Episode Summary
Headaches are incredibly common, but distinguishing tension-type headache, migraine, and cervicogenic headache is key to choosing the right approach. Learn the red flags, the role of neck pain, and why exercise, rehabilitation, or medication may help depending on the source.
Headache assessment here focuses on distinguishing the main types, especially tension-type headache, migraine, and cervicogenic headache. It explains that headaches are extremely common, while new onset after age 50 is unusual and should raise concern for possible red flags. A key concept is that neck pain often accompanies many headache types because of trigeminal-cervical sensory convergence, so neck pain alone does not prove the neck is the source.
Tension-type headache is described as a bilateral, pressing, non-pulsating headache lasting 30 minutes to 7 days, usually without nausea or worsening with activity. Migraine is presented as a neurological disorder with attacks lasting 4 to 72 hours, often one-sided, pulsating, activity-related, and associated with nausea, light sensitivity, and sound sensitivity; the PIN questions are introduced as a quick screening tool. Cervicogenic headache is linked to upper cervical structures and is suggested by reduced neck movement and reproduction of headache with neck provocation.
Treatment expectations are also outlined: migraine generally requires medication, tension-type headache often benefits from a multidisciplinary approach, and cervicogenic headache may improve with upper cervical rehabilitation, exercise, and targeted testing such as the flexion-rotation test.
