Atlanto-Occipital and Lateral Atlanto-Axial Joint Pain Patterns

Dreyfuss, Paul; Michaelsen, M; Fletcher, David

doi:10.1097/00007632-199405001-00005

Cited by 192 publications

(114 citation statements)

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“…Dreyfuss et al [4] showed that an experimental increase in pressure in the atlantoaxial joints by injections caused similar patterns of pain as seen in C1/C2 osteoarthritis and thereby confirmed the role of the atlantoaxial joint as a pain generator.…”

mentioning

confidence: 83%

Atlantoaxial osteoarthritis: case series and review of the literature

Schaeren

Jeanneret

2005

Eur Spine J

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confidence: 83%

Atlantoaxial osteoarthritis: case series and review of the literature

Schaeren

Jeanneret

2005

Eur Spine J

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“…Based on the presence of nerve fibres and the demonstration of substance-P-like and calcitonin gene-related protein-like immunoreactivity within the synovial folds, it is suggested that the synovial folds are potential sources of pain [19,21,26]. Pain originating from the synovial folds of the lateral atlanto-axial joints may manifest as neck pain, which might refer to the head, producing headache [1,6].…”

Section: Introductionmentioning

confidence: 99%

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

2010

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The purpose of this study was to investigate the effect of age, anthropometrics and cervical range of motion upon synovial fold volume. Ten healthy female subjects aged 20-40 years were included in the study. Age, height, body mass, dimensions of the head and neck and cervical range of motion of each subject were measured. Magnetic resonance (MR) images of the cervical spine were acquired; the volume of the ventral and dorsal synovial folds of the right and the left lateral atlanto-axial joints was measured using seed growing and thresholding methods. Using Spearman's correlation coefficient, it was determined that there was no correlation between synovial fold volume and age. Synovial fold volume was positively correlated with subject height and neck length but negatively correlated with body mass, body mass index and the circumference of the head and neck. The relationship between synovial fold volume and range of cervical motion varied with the plane of movement. The ability to image the synovial folds of the lateral atlanto-axial joints using MR imaging to determine their normal morphology provides the basis for investigating synovial fold pathology in patients with neck pain and headache.

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“…Headache can arise from a variety of structures of the cervical spine, including the zygapophyseal joints (occiput-C3). 6,29 Major signs and symptoms of cervicogenic headache usually include unilateral head pain without side-shift, combined with neck pain and restriction of neck movement. 28 Despite the IHS classification, diagnosis of cervicogenic headache is difficult because up to 70% of individuals with frequent intermittent headache report accompanying neck pain.…”

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confidence: 99%

Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache

Hall¹,

Chan²,

Christensen³

et al. 2007

J Orthop Sports Phys Ther

133

110

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Headache is a common condition frequently encountered by physiotherapists in clinical practice. 18 Cervicogenic headache has been classified by the International Headache Society (IHS) 1 and accounts for 15% to 20% of all chronic and recurrent headaches. 20 Individuals with chronic cervicogenic headache experience considerable restriction of daily function, limitation of social participation, and emotional distress. 5 In addition, these t sTudy design: Randomized, double-blind, placebo controlled trial.t objeCTives: To determine the effect of a C1-C2 self-sustained natural apophyseal glide (SNAG) on cervicogenic headache. t baCkground: Cervicogenic headache is a common condition causing significant disability. Recent studies have shown a high incidence of C1-C2 dysfunction, evaluated by the flexion-rotation test (FRT), in subjects with cervicogenic headache. To manage this dysfunction, Mulligan has described a C1-C2 self-SNAG, though no studies have investigated the efficacy of this intervention approach.t meTHods: A sample of 32 subjects (mean 6 SD age, 36 6 3 years) with cervicogenic headache and FRT limitation were randomized into a C1-C2 self-SNAG or placebo group. After an initial instruction and practice visit in the clinic, interventions consisted of exercises applied independently by the subject twice daily at home on a continual basis. FRT range was measured twice, before and immediately after the instruction and practice visit. Headache symptoms were determined by a headache index over time, assessed by questionnaire preintervention, at 4 weeks postintervention, and at 12 months postintervention.t resulTs: No differences were found in baseline measures between groups. Immediately after the initial instruction and practice visit performed with the supervision of the therapist, FRT range increased by 15° (SD, 9) for the C1-C2 self-SNAG group (P,.001), which was significantly more than 5° (SD, 5) for the placebo intervention (P,.001). There was also a significant interaction for the variable headache index between group and time (P,.001), indicating that group difference was dependent on time. There was no difference in headache index scores at baseline between groups. Headache index scores were substantially less in the C1-C2 self-SNAG group (mean 6 SD points at 4 weeks, 31 6 9; mean 6 SD points at 12 months, 24 6 9) compared to the placebo group (mean 6 SD points at 4 weeks, 51 6 15; mean 6 SD points at 12 months, 44 6 13) at 4 weeks (P,.001) and 12 months (P,.001), with an overall (6SD) reduction of 54% (617%) for the individuals in the C1-C2 self-SNAG group.t ConClusions: These results provide evidence for the efficacy of the C1-C2 self-SNAG technique in the management of individuals with cervicogenic headache.

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Atlanto-Occipital and Lateral Atlanto-Axial Joint Pain Patterns

Cited by 192 publications

References 0 publications

Atlantoaxial osteoarthritis: case series and review of the literature

Atlantoaxial osteoarthritis: case series and review of the literature

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

Efficacy of a C1-C2 Self-sustained Natural Apophyseal Glide (SNAG) in the Management of Cervicogenic Headache

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