“You can get past the dead end. You can break through the ceiling. I did and so have countless others.”

Clinical Pearl Wednesday #126

Headache Depression Stress Anxiety  - Engin_Akyurt / Pixabay

Have a patient presenting with an acute/chronic headache or migraine? Then palpate and inspect their head and neck!

It always blows my mind that clinicians do not adequately exam the head and neck of patients who present with headaches. It is one of the FEW body parts that clinicians do not adequately assess in terms of a complaint of pain. If an ankle, abdomen, shoulder, etc. hurts, you typically palpate and look at the area, right? Well, the head shouldn’t be any different.

I couldn’t tell you how many times I have determined that a patients headache was coming from a neck spasm, folliculitis on the scalp, shingles, TMJ, and so forth by simply touching and looking at the patients head. Often, these patients will have seen multiple other providers and physicians without an accurate answer because they failed to touch or look at the painful area the patient was complaining of: their head!

So, if a patient has a headache, do a thorough examination of their head. Sometimes the diagnosis can be as simple as a tight jaw from TMJ, shingles, or a neck spasm.

7 Responses

  1. I suffered from migraines for decades and was under a neurologist care for Botox injections for 2 years (w/o good results). Recently my chiropractor has been adjusting my neck and recommended therapeutic massage- and it was then discussed w/ me that it was due to the tension and stress in my neck and shoulders. Great article!

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