Role and Relevance in Headache Recently, the role and relevance of ‘Yellow Flags’ in chronic pain has been questioned.1 The average length of history of headache/migraine patients presenting to a dedicated headache clinic is 15 years;2 these people therefore often present with chronic pain and are depressed, anxious etc.; this is not unreasonable in the
Questions and Answers Question: In your view, if what appears to be a classical right C2,3 cervicogenic headache and it responds to a Triptan, is the diagnosis CxHA or migraine? Answer: My understanding of CxHA is where (secondary to) a disorder in the upper cervical spine is misinterpreted as residing in the trigeminal field and
The Accompanying Neck Pain The findings and subsequent assumption from a recent observational Italian study,1 ‘When cervical pain is actually migraine: An observational study in 207 patients.’, challenge basic neuro/anatomical/physiological principles. This survey sought to assign a headache diagnosis to a cohort of 132 participants who had self-diagnosed their headache as being of cervical in origin.
An Underlying Disorder What else can I say but… there are those who are innately intuitive. Considering the cause of headache and migraine, I have just come across a gentleman(1) who in 1888 described the migraine process in this way: “… we must not ascribe too much significance to throbbing of the increase in the
Why Treatment Often Fails Several authorities recently summarised the reasons why headache and migraine treatment often fails. Amongst other things, they suggested that the diagnosis is incomplete or incorrect and that this could occur for various reasons. One of the reasons is ‘misdiagnosis’. I have mentioned this research before but diagnosing headache and migraine is like
Decreases Migraine Progression Recent evidence suggests that migraine is a progressive condition in which over time, episodes become more frequent, more severe, less responsive to medication, and last longer. Research has shown that by (surgically) treating/removing disorders (which were evident on an MRI scan) in the upper cervical (neck) decreased the long-term worsening of the
