Luedtke Kerstin, May Arne
Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
J Headache Pain. 2017 Sep 26;18(1):97. doi: 10.1186/s10194-017-0808-0.
Migraine patients usually report a high prevalence of neck pain preceding or during the migraine attack. A recent investigation of musculoskeletal dysfunctions in migraine patients concluded that neck pain is not simply a symptom of the migraine attack but corresponds to identifiable muscle and joint alterations. Particularly pain provocation using palpation of the joints in the upper cervical spine was significantly more prevalent in patients with migraine than in headache-free participants.
One hundred seventy-nine migraineurs (diagnosed according to IHS classification criteria version III beta) and 73 age- and gender-matched healthy controls were examined by a physiotherapist blinded towards the diagnosis, using a palpation technique over the upper cervical spine. The palpation combined oscillating movements and sustained pressure.
Using simple palpation of the upper cervical spine, migraine patients can be stratified into three groups: painfree (11%), local pain only (42%), and pain referred to the head during sustained pressure (47%). Combining both test components (palpation and sustained pressure) has a high sensitivity and specificity for migraine.
The response to palpation of the upper cervical spine may indicate migraine subtypes. The presence of musculoskeletal dysfunctions of the upper cervical spine should be identified and treated to avoid ongoing nociceptive input into the trigeminocervical complex.
German Clinical Trial Register DRKS-ID: DRKS00009622 .
偏头痛患者通常报告在偏头痛发作之前或发作期间颈部疼痛的发生率很高。最近一项对偏头痛患者肌肉骨骼功能障碍的调查得出结论，颈部疼痛不仅仅是偏头痛发作的症状，而是与可识别的肌肉和关节改变相对应。特别是，通过触诊上颈椎关节诱发疼痛在偏头痛患者中比无头痛的参与者更为普遍。
由一名对诊断不知情的物理治疗师，使用对上颈椎的触诊技术，对179名偏头痛患者（根据国际头痛协会（IHS）III beta版分类标准诊断）和73名年龄及性别匹配的健康对照者进行检查。触诊结合了摆动动作和持续压力。
通过对上颈椎的简单触诊，偏头痛患者可分为三组：无痛（11%）、仅局部疼痛（42%）和在持续压力期间疼痛放射至头部（47%）。将两种测试成分（触诊和持续压力）结合起来对偏头痛具有高敏感性和特异性。
对上颈椎触诊的反应可能表明偏头痛的亚型。应识别并治疗上颈椎的肌肉骨骼功能障碍，以避免持续的伤害性输入进入三叉神经颈复合体。
德国临床试验注册中心DRKS-ID：DRKS00009622 。
