107 - Neck Pain and Headache: Improving Diagnosis and Treatment for Workers

Headache is a leading cause of disability, absenteeism, and presenteeism. The goal of the session is to challenge our current approach to neck pain and headache, create new diagnostic paradigms, and improve treatment outcomes in injured workers. What is the relationship between neck pain and headache? Which comes first; the headache or the neck pain? When is a headache a migraine, cervicogenic headache, or tension headache? The pain pathway for neck pain and headache are both mediated via the spinotrigeminal nucleus, which extends from the upper cervical spine (C3) to the midbrain. This interplay is important for both diagnosis and treatment. This case presentation will begin with a patient complaining of headache after a work injury; we will discuss the diagnostic criteria, comorbidities, and symptoms that are common with different types of headaches. The same case will then be presented as a worker who presents with neck pain. This process will stress how the initial chief complaint can alter diagnostic accuracy and treatment options. Understanding how neck pain and headache interact will lead to better patient outcomes and return to work.