When Headache Starts in the Neck: Gwen Jull & Zhiqi Liang on Migraine, Cervicogenic Headache, and Clinical Reasoning
About this episode
This episode discusses the relationship between neck pain and headaches, emphasizing the need for careful clinical reasoning in diagnosis and treatment.
Neck pain and headache often travel together. But as Gwen Jull and Zhiqi Liang explain in this episode, that does not automatically mean the cervical spine is driving the headache. In this AAOMPT and IFOMPT collaborative episode, hosts Amy McDevitt and Michael Boney explore the evolving science around cervicogenic headache, migraine-associated neck pain, sensitization, and clinical examination. Gwen Jull discusses the development and validation of physical criteria for cervicogenic headache, emphasizing the need for a cluster of comparable musculoskeletal signs involving joint, movement, and muscle impairments. Zhiqi Liang expands the conversation into migraine, reminding clinicians that neck pain can be part of a migraine presentation rather than proof of a cervical source. She challenges clinicians to rethink the meaning of symptom reproduction during upper cervical examination and to consider sensitivity, irritability, and migraine cycles when examining and treating these patients. Together, the guests make a compelling case for more careful clinical reasoning: listen to the patient’s story, examine without over-provoking symptoms, look for comparable signs, and match…
People in this episode
Hosts: Amy McDevitt, Michael Boney
Guests: Gwen Jull, Zhiqi Liang
Topics covered
- cervicogenic headache
- migraine
- clinical reasoning
- neck pain
- musculoskeletal signs
Keywords
- cervicogenic headache
- migraine
- neck pain
- clinical examination
- musculoskeletal signs
Mentioned in this episode
Organizations: AAOMPT, IFOMPT
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