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Head & neck pain review: traditional & new perspectives

  [ 53 votes ]   [ Discuss This Article ] • October 15, 1996

A variety of conditions are frequently associated with the
occurrence of head and neck pain. The purposes of this review
are: to describe the characteristics of several
musculoskeletal, neurological, and systemic conditions
frequently cited as possible causes of head and neck pain and
to suggest a new technique for treating head and neck pain.
The characteristics of musculoskeletal conditions, such as
muscle spasm, tendinitis, trigger points, and joint
inflammation, and their relationship to head and neck pain
are considered. The features and clinical implications of
neurologic conditions, such as atypical facial pain,
trigeminal and glossopharyngeal neuralgia, reflex sympathetic
dystrophy, and neurogenic inflammation, are also described.
The distinguishing characteristics of headaches, including
cluster, tension, chronic daily, rebound, posttraumatic, and
postlumbar puncture, are detailed. This review also addresses
the contributions of systemic disorders, such as
osteoarthritis, rheumatoid arthritis and the variants, and
rheumatoid-related conditions, like dermatomyositis, temporal
arteritis, Lyme's disease, and fibromyalgia, to head and neck
pain. The results of a recent pilot study of the effectiveness
of intraoral circulating ice water for resolving symptoms
related to head and neck pain secondary to neurogenic
inflammation are presented in this work. Ice water
circulating through hollow metal tubes was placed intraorally
for 15 minutes in the posterior maxillary area on 12
individuals with cervical pain and muscle spasm. In nine of
these individuals, reduced cervical pain perception, upper
trapezius electromyography signal reduction, and increased
cervical range of motion was produced. Six out of 12
individuals had accompanying headache, which was reduced or
eliminated in four cases. These findings suggest a strong
trigemino-cervical relationship to neck pain and headache.

Friedman MH, Nelson AJ Jr

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