Diagnosing Headache Pain After Whiplash

Diagnosing Headache Pain After Whiplash

Many victims of whiplash injury complain of headache immediately following the trauma. Clinicians and researchers have documented persistent headaches occurring years after the initial trauma. Pain in the head can be a difficult finding to correlate clinically and this is even more important in head pain caused by whiplash. In a recent publication in a premier headache medical journal, Becker (2010) wrote about neck injury causing headache. The name of the headache that is caused by an injury to the neck is called cervicogenic headache and is different from migraine or tension headache.

The author states, “Although the concept of headaches originating from the cervical spine was described as early as 1860, and the term ‘cervicogenic headache’ was coined over 2 decades ago in 1983, a firm clinical diagnostic paradigm that most clinicians can use with confidence is still lacking” (Becker, 2010, p. 699). This paper is about that protocol and how to objectify this condition. The author continues to describe the diagnostic dilemma by stating, “Neurologists are the specialist to whom headaches patients are referred to most often, and neurologists are often not expert in the examination of the neck” (Becker, 2010, p. 701). Examination by a clinician that has expertise in headaches, whiplash trauma and the cervical spine is critical.

A MAJOR feature of this pain is “…posterior onset of the headache pain…” (Becker, 2010, p. 700). The author concludes, “Its existence [cervicogenic headache] should not seem surprising, given that the upper neck has many pain sensitive structures, and that the innervation of these structures is such that pain referral from these structures, even to the orbit [eye], is possible” (Becker, 2010, p. 704).

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Reference:

Becker, W. J. (2010). Cervicogenic headache: Evidence that the neck is a pain generator. Headache: The Journal of Head and Face Pain, 50(4), 699-705.