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Chiropractic Research Review

A Musculoskeletal Connection to Cervicogenic Headache

The impact of headaches on quality of life often exceeds the impact of other chronic conditions such as osteoarthritis, hypertension or diabetes. However, the diverse nature of headaches and their symptoms has contributed to a great disparity in causation theories and management tactics for this frustrating condition.

This review of the literature evaluated the neurophysiologic basis and anatomical relationship between the dura mater and the rectus capitis posterior minor muscle, specifically in an attempt to find a potential causal link to cervicogenic headache.

Studies were limited to those dealing with participants designated as "benign headache patients." The search strategy included searches of MEDLINE and the Index to Chiropractic Literature, manual citation searches, and peer inquiries.

The authors conclude that:

* The literature suggests a neurophysiologic mechanism for headaches in the presence of cervical spine joint complex dysfunction.

* Dura-muscular, dura-ligamentum nuchae connections in the upper cervical spine may have the potential to produce cranial pain in the presence of functional pathosis.

* Understanding this proposed rationale may help clinicians initiate a conservative protocol of spinal manipulation for patients presenting with chronic benign headache - a course of treatment shown to be effective for headaches with cervicogenic, migraine and tension-type manifestations.

Alix ME, Bates DK. A proposed etiology of cervicogenic headache: the neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle. Journal of Manipulative and Physiological Therapeutics, Oct. 1999:22(8), pp534-39.
Reprints: Tel: (800) 325-4177 (ext. 4350); Fax: (314) 432-1380

Chiropractic Research Review

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