Increased mechanosensivity of the greater occipital nerve in subjects with side-dominant head and neck pain – a diagnostic case-control study

Szikszay, Tibor M.; Luedtke, Kerstin; von, Piekartz Harry

doi:10.1080/10669817.2018.1480912

Cited by 21 publications

(9 citation statements)

References 91 publications

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“…In line with most of the previous research assessing musculoskeletal pain in NSNP [13,26,41,43,47,48,49,50,51,52,53,54], our findings showed increased sensitivity to pressure stimuli on the necks of females with NSNP compared to healthy controls. Local hyperalgesia is a common feature of individuals suffering from chronic NSNP [6], which may reflect peripheral and segmentally related spinal cord sensitization [26].…”

Section: Discussionsupporting

confidence: 92%

Local and Widespread Pressure Pain Hyperalgesia Is Not Side Specific in Females with Unilateral Neck Pain that Can Be Reproduced during Passive Neck Rotation

Piña-Pozo

Heredia-Rizo

Madeleine

et al. 2019

JCM

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Current evidence for widespread hyperalgesia in non-specific neck pain (NSNP) is unclear. It is currently recommended to group NSNP patients according to pain-provoking movements. The aim of this study was to investigate local and widespread pain sensitivity in females with unilateral NSNP that is reproducible during passive neck rotation compared with matched controls, and to compare the side specific effect of pain location on pressure pain sensitivity among females with unilateral NSNP. Thirty-six females with unilateral NSNP evoked during passive ipsilateral (n = 20) or contralateral (n = 16) rotation toward the painful side were compared with 20 controls. Participants reported their pain intensity at rest and during passive neck rotation and completed the Neck Disability Index. Pressure pain thresholds (PPTs) were assessed bilaterally over the anterior scalene; the sternocleidomastoid; the levator scapulae; lateral to the spinous process of C6; the median, ulnar, and radial nerves; and the tibialis anterior. The ANOVA revealed lower PPTs in females with unilateral NSNP compared with the controls (all at p < 0.001), but no differences were found between the sides, nor was there any Group × side interaction. Among females with NSNP, those with higher pain intensity during ipsilateral rotation toward the painful side showed lower PPTs over the anterior scalene, median nerve, ulnar nerve, and tibialis anterior (all, p < 0.05) than females with higher pain intensity during contralateral rotation toward the painful side. These findings demonstrated bilateral local and widespread pressure pain hyperalgesia in females with unilateral NSNP that was reproducible during passive neck rotation compared with controls. There was no side specific effect of pain location on PPTs among females with unilateral NSNP.

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Section: Discussionsupporting

confidence: 92%

Local and Widespread Pressure Pain Hyperalgesia Is Not Side Specific in Females with Unilateral Neck Pain that Can Be Reproduced during Passive Neck Rotation

Piña-Pozo

Heredia-Rizo

Madeleine

et al. 2019

JCM

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“…This position will create tensioning of the anterior meningovertebral ligaments and might have an impact on dura tension during upper cervical movement. This could potentially explain positive neural tension testing such as the slump test in subjects with cervicogenic and tension type headache ( Caamano-Barrios et al, 2019 ; Szikszay, Luedtke & Von Harry, 2018 ; Von Piekartz, Schouten & Aufdemkampe, 2007 ). It was the aim of this cadaver study to further explore if there were direct soft tissue connections between the nuchal ligament and the dura mater in the upper cervical region and use histology to identify the type of soft tissue connection with the dura.…”

Section: Introductionmentioning

confidence: 99%

Anatomy and clinical relevance of sub occipital soft tissue connections with the dura mater in the upper cervical spine

Sillevis¹,

Hogg²

2020

PeerJ

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Background The upper cervical region is a complex anatomical structure. Myodural bridges between posterior suboccipital muscles and the dura might be important explaining conditions associated with the upper cervical spine dysfunction such as cervicogenic headache. This cadaver study explored the upper cervical spine and evaluated the myodural bridges along with position of spinal cord in response to passive motion of upper cervical spine. Methods A total of seven adult cadavers were used in this exploratory study. The suboccipital muscles and nuchal ligament were exposed. Connections between the Rectus Capitis Posterior major/minor and the Obliquus Capitis minor, the nuchal ligament, posterior aspect of the cervical spine, flavum ligament and the dura were explored and confirmed with histology. The position of the spinal cord was evaluated with passive motions of the upper cervical spine. Outcomes In all cadavers connective tissues attaching the Rectus Capitis Posterior Major to the posterior atlanto-occipital membrane were identified. In the sagittal dissection we observed connection between the nuchal ligament and the dura. Histology revealed that the connection is collagenous in nature. The spinal cord moves within the spinal canal during passive movement. Discussion The presence of tissue connections between ligament, bone and muscles in the suboccipital region was confirmed. The nuchal ligament was continuous with the menigiovertebral ligament and the dura. Passive upper cervical motion results in spinal cord motion within the canal and possible tensioning of nerve and ligamentous connections.

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“…Pressure pain threshold 33,34,44,46---53 Heat and cold pain threshold 54 Von Frey hairs 55 Mechanosensitivity of neural tissue 34,56 Tactile acuity 57 Muscle strength, function, and endurance Cervical and shoulder girdle strength 22,26,36,58 Endurance of the neck flexors 36 Craniocervical flexion test 22,26 In addition to a greater prevalence of neck pain, patients with migraine also show a higher prevalence of temporomandibular disorders (TMD). 65 The presence of TMD can be considered a risk factor for an increased frequency of headache and therefore the development of chronic migraine.…”

Section: Sensory Testingmentioning

confidence: 99%

Physical therapy and migraine: musculoskeletal and balance dysfunctions and their relevance for clinical practice

Carvalho

Schwarz

Szikszay

et al. 2020

Brazilian Journal of Physical Therapy

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Background: Migraine is a primary headache with high levels of associated disability that can be related to a variety of symptoms and comorbidities. The role of physical therapy in the management of migraine is largely unknown. Therefore, the aim of this review is to highlight and critically discuss the current literature and evidence for physical therapy interventions in individuals with migraines. Methods: A narrative review of the literature was performed. Results: Physical therapists assessing and treating patients with migraine should focus on two primary aspects: (1) musculoskeletal dysfunctions, and (2) vestibular symptoms/postural control impairment. Signs and symptoms of musculoskeletal and/or vestibular dysfunctions are prevalent among individuals with migraines and different disability levels can be observed depending on the presence of aura or increment of the migraine attacks. Conclusion: A proper physical examination and interview of the patients will lead to a tailored treatment plan. The primary aim regarding musculoskeletal dysfunctions is to reduce pain and sensitization, and physical therapy interventions may include a combination of manual therapy, exercise therapy, and education. The aim regarding postural control impairment is to optimize function and reduce vestibular symptoms, and interventions should include balance exercises and vestibular rehabilitation. However, consistent evidence of benefits is still lacking due to the lack of and therefore need for tailored and pragmatic clinical trials with high methodological quality.

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Increased mechanosensivity of the greater occipital nerve in subjects with side-dominant head and neck pain – a diagnostic case-control study

Cited by 21 publications

References 91 publications

Local and Widespread Pressure Pain Hyperalgesia Is Not Side Specific in Females with Unilateral Neck Pain that Can Be Reproduced during Passive Neck Rotation

Local and Widespread Pressure Pain Hyperalgesia Is Not Side Specific in Females with Unilateral Neck Pain that Can Be Reproduced during Passive Neck Rotation

Anatomy and clinical relevance of sub occipital soft tissue connections with the dura mater in the upper cervical spine

Physical therapy and migraine: musculoskeletal and balance dysfunctions and their relevance for clinical practice

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