Head & neck pain review: traditional & new perspectives

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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