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.