The Chinese Association for the Study of Pain (CASP): Expert Consensus on the Cervicogenic Headache

Xiao, Hong; Peng, Baogan; Ma, Ke; Huang, Dong; Liu, Xian-Guo; Lu, Yan; Liu, Qing; Lu, Lijuan; Liu, Jingfeng; Li, Yimei; Song, Tao; Tao, Wei; Shen, Wen; Yang, Xiaobin; Wang, Lin; Zhang, Xiaomei; Zhuang, Zhi-Gang; Liu, Hui; Liu, Yanqing

doi:10.1155/2019/9617280

Cited by 12 publications

(11 citation statements)

References 38 publications

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“…Earlier studies suggested that overactivation of the upper three cervical spinal nerves is the cause of most CEHs. 25 There are anatomical connections between the C1, C2, and C3 spinal nerves and the trigeminal cervical complex that converge the sensory pathways of the upper cervical spine and trigeminal nerve and inducing pain in the occipital, forehead, temporal and orbital areas. 26,27 Interestingly, this study found that lower cervical (below C4) RFA is also effective in patients with discogenic CEH.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography‐guided radiofrequency ablation of cervical intervertebral discs for the treatment of refractory cervicogenic headache: A retrospective chart review

Zhang

et al. 2022

Headache

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Objective To evaluate the feasibility and efficacy of computed tomography (CT)‐guided radiofrequency ablation (RFA) of cervical intervertebral discs for the treatment of discogenic cervicogenic headache (CEH). Background Some patients with CEH experience no obvious therapeutic effect after conventional therapy, particularly patients with refractory CEH originating from abnormal cervical intervertebral discs. Treatment for this type of CEH remains poorly characterized. Methods Using a single intervention arm, pretest/posttest design, we retrospectively analyzed the data of patients who underwent CT‐guided RFA of cervical intervertebral discs for CEH at the Pain Medicine Center of Zhejiang Provincial People’s Hospital from January 2017 to April 2021. If conservative treatment failed in patients with discogenic CEH, we classified the patients as having refractory CEH and performed RFA of cervical intervertebral discs. We used a numeric rating scale (NRS) to assess pain intensity for 6 months. We also compared therapeutic outcome of patients with different characteristics. Results A total of 44 patients who underwent CT‐guided RFA of cervical intervertebral discs were enrolled and 41 of them were analyzed in the present study. The preoperative median (25th, 75th) NRS score was 4 (4, 5), and it was significantly reduced to 1 (0, 4) 6 months after RFA (p < 0.001). The number of patients with ≥50% of their pain relieved after 6 months was 28 of 41 (68%). No serious treatment‐related complications occurred in this study. Compared with single‐level RFA, multi‐level RFA shows greater effects on pain intensity reduction (p = 0.032) and pain relief rate (p = 0.047) of patients. Conclusion In patients who have discogenic CEH, CT‐guided RFA of the cervical intervertebral discs appears to be a promising treatment with no serious complications.

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Section: Discussionmentioning

confidence: 99%

Computed tomography‐guided radiofrequency ablation of cervical intervertebral discs for the treatment of refractory cervicogenic headache: A retrospective chart review

Zhang

et al. 2022

Headache

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“…C2-3 posterior medial branch radiofrequency (RF) intervention is conditionally recommended for patients with persistent cervicogenic headache. Imaging technologies (ultrasound, X-ray and computed tomography) are recommended to guide invasive therapies[ 2 ].…”

Section: Guidelinesmentioning

confidence: 99%

Editorial for the special issue of the Chinese Association for the Study of Pain

Peng¹,

Liu²,

Ma³

2021

WJCC

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The Ministry of Health of China officially issued a document, adding the first level diagnosis and treatment discipline “Algology” in the list of diagnosis and treatment subjects of medical institutions on July 16, 2007. As the most important pain academic organization in China, the Chinese Association for the Study of Pain has made outstanding contributions in promoting the development of pain discipline and in establishing pain standards and disease diagnosis and treatment guidelines. In this special issue, under the leadership of Yan-Qing Liu, Chairman of the 7 th Committee of the Chinese Association for the Study of Pain, nine consensus and one guideline were included.

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“…The duration of the attacks is typically one to three days but may range from hours to one week (Barmherzig & Kingston, 2019;Gallagher, 2007;Blumenfeld & Siavoshi, 2018;Xiao et al, 2019;Antonaci & Inan, 2021). Some reports suggest a role of cervical structures, such as vertebrae, intervertebral discs, uncovertebral joints, vertebral arteries, and cervical roots as headache triggers (Fredriksen, Hovdal & Sjaastad, 1987;Becker, 2010).…”

Section: Introductionmentioning

confidence: 99%

Postural physiotherapy for cervicogenic headache after occipital nerve block: a retrospective study

César

Costa

Botelho

et al. 2021

RSD

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Cervicogenic headache has a complex and poorly understood pathophysiology. Symptoms are typical and involve the C2 and C3 nerve roots. There are no specific recommendations for physical therapy, although occipital nerve block is a known pharmacological treatment. Some evidence suggests that hip rotation correction could aid in reducing cervical pain symptoms. The objective of this work is to evaluated the role of postural physiotherapy for hip rotation correction using the Maitland technique in patients with cervicogenic headache who underwent an occipital nerve block. In this retrospective, observational and uncontrolled study, patients were evaluated from January 2017 to February 2018. After diagnosis of cervicogenic headache they underwent anesthetic block, hip radiography with lower limb scanometry and cervical tomography, after which they were referred to physical therapy. The analog pain scale was used for evaluation at the time of diagnosis and after the proposed physiotherapy. Patients submitted to an occipital nerve block were divided into three groups: Group I (n = 15, physical therapy with Maitland technique) had an analog pain score of 1.6 after the physical therapy, Group II (n = 11, conventional physiotherapy) had an analog pain score of 3.7 after the physical therapy and Group III (n = 13, occipital nerve block only) had an analog pain score of 5.2 after the occipital nerve block. The results suggest that an occipital nerve block in combination with the Maitland technique is superior in patients with cervicogenic headache compared to nerve block only or blockade combined with non-specific physical therapy (p=0,013).

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The Chinese Association for the Study of Pain (CASP): Expert Consensus on the Cervicogenic Headache

Cited by 12 publications

References 38 publications

Computed tomography‐guided radiofrequency ablation of cervical intervertebral discs for the treatment of refractory cervicogenic headache: A retrospective chart review

Computed tomography‐guided radiofrequency ablation of cervical intervertebral discs for the treatment of refractory cervicogenic headache: A retrospective chart review

Editorial for the special issue of the Chinese Association for the Study of Pain

Postural physiotherapy for cervicogenic headache after occipital nerve block: a retrospective study

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