Hutting Nathan, Mourad Firas, Kranenburg Rik, Wilbrink Wilfred, Kerry Roger, Taylor Alan
J Orthop Sports Phys Ther. 2023 Feb;53(2):59-63. doi: 10.2519/jospt.2022.11568. Epub 2022 Oct 28.
Neck pain, headache, and/or orofacial symptoms are potentially the first (nonischemic) symptoms of an underlying vascular pathology or blood flow limitation. If an underlying vascular pathology or blood flow limitation is not recognized by the musculoskeletal rehabilitation clinician, it can subsequently be aggravated by treatment, raising the risk of serious adverse events. We argue that clinicians can make an important, and potentially lifesaving, difference by providing specific information and advice. This is especially the case in patients with an intermediate level of concern, for example, in patients who only show a few concerning features regarding a possible underlying serious condition and for whom an initial vasculogenic hypothesis was rejected during the clinical reasoning process. We present background information to help the reader understand the context of the problem and suggestions for how clinicians can provide appropriate information and advice to patients who present with neck pain, headache, and/or orofacial symptoms. .
颈部疼痛、头痛和/或口面部症状可能是潜在血管病变或血流受限的首发（非缺血性）症状。如果肌肉骨骼康复临床医生未识别出潜在的血管病变或血流受限，后续治疗可能会使其加重，增加严重不良事件的风险。我们认为，临床医生通过提供特定信息和建议可以产生重要且可能挽救生命的影响。对于中度担忧的患者尤其如此，例如，仅表现出一些可能存在潜在严重疾病相关特征且在临床推理过程中最初的血管源性假设被否定的患者。我们提供背景信息以帮助读者理解问题的背景，并就临床医生如何向出现颈部疼痛、头痛和/或口面部症状的患者提供适当信息和建议提出建议。
