Publication: Fisioterapia en la Cefalea Cervicogénica
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2019-05
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Abstract
Introducción: La cefalea cervicogénica es un síndrome doloroso cuya fisiopatología está relacionada con la convergencia funcional de información en el núcleo trigémino cervical, entre la información aferente de las estructuras de la región cervical superior y las aferencias sensitivas del tracto descendente del trigémino. Este proceso, sumado a la sensibilización central que se origina en este núcleo, desencadena una cefalea generalmente hemicraneal acompañada de una reducción del movimiento cervical y dolor occipital. Provoca discapacidad en la realización de las actividades de la vida diaria en la mayoría de los pacientes, aunque el grado de discapacidad desencadenado es menor que el de otras cefaleas como la migraña. Igualmente desencadena pérdidas económicas cuantiosas debido a su relativa frecuencia en la sociedad.
Metodología: Utilizando las bases de datos PubMed, PEDro, Cochrane Library y SciELO, se ha realizado esta revisión narrativa que incluye publicaciones desde el 2001 hasta marzo de 2019, sobre el abordaje fisioterapéutico de la cefalea cervicogénica.
Desarrollo: La fisioterapia juega un papel clave en el tratamiento de este síndrome. Entre las diferentes técnicas que podemos aplicar desde esta disciplina se encuentran fundamentalmente el ejercicio terapéutico, la punción seca, o el tratamiento manual de la región cervical y craneocervical, así como de la articulación temporomandibular donde se incluyen la manipulación y la movilización articulares.
Conclusión: la manipulación y la movilización son las técnicas de mayor evidencia científica. Aunque otras como el ejercicio terapéutico o la punción seca también resultan de utilidad. No debemos olvidar la relevancia del abordaje multidisciplinar.
Introduction: The cervicogenic headache syndrome come from the functional information convergence at the trigeminocervical nucleus, where sensory nerve fibers of the descending tract of the trigeminal nerve are believed to interact with sensory fibers that send upper cervical sensory information. A central sensitization of the trigeminocervical nucleus is added to this mechanism, triggering unilateral head pain, restricted cervical range of motion and occipital pain. This syndrome causes substantial disability and economic loss because its high frequency in the population. Methodology: a narrative review that collect the physical therapy treatment in the cervicogenic headache publications since 2001 to March 2020. The data bases used were PubMed, PEDro, Cochrane Library and SciELO. Development: the physical therapy is one of the most useful tools for this syndrome treatment. We can find a large assortment of techniques such as therapeutic exercise, dry needling manual physiotherapy for the cervical, occipital and temporomandibular regions, including manipulation and mobilization. But the two latest’s ones have the most scientist evidence. Conclusion: manipulation and mobilization have the most scientist evidence. But other techniques like therapeutic exercise or dry needling are also useful. The multidisciplinary approach is a key aspect of cervicogenic management
Introduction: The cervicogenic headache syndrome come from the functional information convergence at the trigeminocervical nucleus, where sensory nerve fibers of the descending tract of the trigeminal nerve are believed to interact with sensory fibers that send upper cervical sensory information. A central sensitization of the trigeminocervical nucleus is added to this mechanism, triggering unilateral head pain, restricted cervical range of motion and occipital pain. This syndrome causes substantial disability and economic loss because its high frequency in the population. Methodology: a narrative review that collect the physical therapy treatment in the cervicogenic headache publications since 2001 to March 2020. The data bases used were PubMed, PEDro, Cochrane Library and SciELO. Development: the physical therapy is one of the most useful tools for this syndrome treatment. We can find a large assortment of techniques such as therapeutic exercise, dry needling manual physiotherapy for the cervical, occipital and temporomandibular regions, including manipulation and mobilization. But the two latest’s ones have the most scientist evidence. Conclusion: manipulation and mobilization have the most scientist evidence. But other techniques like therapeutic exercise or dry needling are also useful. The multidisciplinary approach is a key aspect of cervicogenic management