Nagasawa A, Sakakibara T, Takahashi A
Department of Neurology, Nagoya University School of Medicine, Japan.
Headache. 1993 Feb;33(2):90-5. doi: 10.1111/j.1526-4610.1993.hed3302090.x.
Roentgenographic studies were carried out on 372 patients with tension-type headache and 225 normal control subjects to determine relationships between straightened cervical spines, low-set shoulders, and cervical spine instability. A great majority of the patients with tension-type headache were found also to have straightened cervical spine. Patients with tension-type headache may have a restricted progression of the cervical spinal lordosis, which results in a straightened cervical spine. The flexor muscles of the head and neck prevent physiological lordosis of the cervical spine, and their sustained chronic contraction may be a principal cause of a straightened neck. The low-set shoulder was frequently seen in patients with tension-type headache, and it may result in traction of the brachial plexus, which gives rise to pain in the neck and shoulders. Cervical spine instability, on the other hand, was rather infrequent in patients with tension-type headache. Its relationship to tension-type headache is unclear and warrants further study. Our results suggest that both a straightened cervical spine and low-set shoulders may play an important role in the pathogenesis of tension-type headache and its accessory symptoms.
对372例紧张型头痛患者和225名正常对照者进行了X线检查，以确定颈椎变直、肩膀低垂与颈椎不稳之间的关系。发现绝大多数紧张型头痛患者也存在颈椎变直的情况。紧张型头痛患者的颈椎前凸可能进展受限，从而导致颈椎变直。头颈部的屈肌会阻碍颈椎的生理前凸，其持续的慢性收缩可能是颈部变直的主要原因。紧张型头痛患者中经常可见肩膀低垂，这可能会导致臂丛神经受牵拉，进而引起颈部和肩部疼痛。另一方面，颈椎不稳在紧张型头痛患者中相对少见。其与紧张型头痛的关系尚不清楚，值得进一步研究。我们的结果表明，颈椎变直和肩膀低垂可能在紧张型头痛及其伴随症状的发病机制中起重要作用。
