Physiotherapie bei Kopfschmerzen vom Spannungstyp und Migräne

ZUSAMMENFASSUNG

Migräne und Kopfschmerzen gehen oft mit Nackenschmerzen einher. Ob die Nackenschmerzen Symptom, Auslöser oder aufrechterhaltender Faktor der Kopfschmerzen sind, muss im Einzelfall durch eine Anamnese und eine evidenzbasierte Untersuchung festgestellt werden. Grundlage für diese Wechselwirkungen sind Konvergenzen des N. trigeminus mit afferenten Fasern der Spinalnerven C1–3 im trigeminalen Kerngebiet. Es existieren mittlerweile mehrere Übersichtsarbeiten, in denen muskuloskelettale Auffälligkeiten sowie die Wirksamkeit physiotherapeutischer Techniken analysiert werden. Demnach werden 5 physiotherapeutische Tests empfohlen, die bei Patienten mit Migräne häufiger positiv sind als bei Kontrollprobanden. In mehreren Reviews wird auf die Notwendigkeit einer Kombination von Techniken hingewiesen (Hands-off und Hands-on). Durch diese multimodalen Ansätze lassen sich bei einem Teil der Patienten Kopfschmerzen lindern und Migräneattacken reduzieren. Weitere methodisch solide Studien sind notwendig, um die Ergebnisse zu stützen.

ABSTRACT

Migraine and headache are often associated with neck pain. Whether neck pain is a symptom, trigger, or maintaining factor of headache must be determined on a case-by-case basis and by anamnesis and evidence-based examination. The basis for these interactions is convergences of the trigeminal nerve with afferent fibers of spinal nerves C1–3 in the trigeminal nucleus area. Several reviews now exist in which musculoskeletal abnormalities and the efficacy of physiotherapeutic techniques have been analyzed. According to these, five physiotherapeutic tests are recommended, which are more frequently positive in patients with migraine than in control subjects. Several reviews point out the need for a combination of techniques (hands-off and hands-on). These multimodal approaches can relieve headaches in some patients and reduce migraine attacks. Further studies with low risk of bias are needed to support the results.

Schlüsselwörter

Physiotherapie - Kopfschmerzen vom Spannungstyp - Migräne - Evidenz - Edukation

Key words

Physiotherapy - tension-type headache - migraine - evidence - education

Publication History

Article published online:
13 March 2024

• Literatur

• 1 Al-Khazali HM, Younis S, Al-Sayegh Z. et al Prevalence of neck pain in migraine: A systematic review and meta-analysis. Cephalalgia 2022; 42: 663-673
• 2 Ashina S, Bendtsen L, Lyngberg AC. et al Prevalence of neck pain in migraine and tension-type headache: a population study. Cephalalgia 2015; 35: 211-219
• 3 Moore CS, Sibbritt DW, Adams J. A critical review of manual therapy use for headache disorders: prevalence, profiles, motivations, communication and self-reported effectiveness. BMC Neurology 2017; 17: 61
• 4 Gaul C, Eismann R, Schmidt T. et al Use of complementary and alternative medicine in patients suffering from primary headache disorders. Cephalalgia 2009; 29: 1069-1078
• 5 Fernández-de-las-Peñas C, Alonso-Blanco C, Cuadrado ML. et al Myofascial trigger points and their relationship to headache clinical parameters in chronic tension-type headache. Headache 2006; 46: 1264-1272
• 6 Marklund S, Wiesinger B, Wänman A. Reciprocal influence on the incidence of symptoms in trigeminally and spinally innervated areas. European Journal of Pain 2010; 14: 366-371
• 7 Bogduk N, Govind J. Cervicogenic headache: an assessment of the evidence on clinical diagnosis, invasive tests, and treatment. The Lancet Neurology 2009; 08: 959-968
• 8 Bartsch T, Goadsby PJ. Increased responses in trigeminocervical nociceptive neurons to cervical input after stimulation of the dura mater. Brain 2003; 126: 1801-1813
• 9 Bogduk N. Anatomy and physiology of headache. Biomedicine & pharmacotherapy 1995; 49: 435-445
• 10 Bartsch T, Goadsby PJ. Anatomy and physiology of pain referral patterns in primary and cervicogenic headache disorders. Headache Currents 2005; 02: 42-48
• 11 Watson DH, Drummond PD. Head pain referral during examination of the neck in migraine and tension-type headache. Headache 2012; 52: 1226-1235
• 12 Watson DH, Drummond PD. Cervical referral of head pain in migraineurs: effects on the nociceptive blink reflex. Headache 2014; 54: 1035-1045
• 13 Luedtke K, May A. Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine. J Headache Pain 2017; 18: 97
• 14 Rota E, Zucco R, Guerzoni S. et al Migraine Awareness in Italy and the Myth of “Cervical Arthrosis”. Headache 2020; 60: 81-89
• 15 Viana M, Khaliq F, Zecca C. et al Poor patient awareness and frequent misdiagnosis of migraine: findings from a large transcontinental cohort. Eur J Neurol 2020; 27: 536-541
• 16 Viana M, Sances G, Terrazzino S. et al When cervical pain is actually migraine: An observational study in 207 patients. Cephalalgia 2018; 38: 383-388
• 17 Luedtke K, Boissonnault W, Caspersen N. et al International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study. Man Ther 2016; 23: 17-24
• 18 Luedtke K, Starke W, May A. Musculoskeletal dysfunction in migraine patients. Cephalalgia 2018; 38: 865-875
• 19 Szikszay TM, Hoenick S, von Korn K. et al Which Examination Tests Detect Differences in Cervical Musculoskeletal Impairments in People With Migraine? A Systematic Review and Meta-Analysis. Physical Therapy 2019; 99: 549-569
• 20 Liang Z, Galea O, Thomas L. et al Cervical musculoskeletal impairments in migraine and tension type headache: A systematic review and meta-analysis. Musculoskeletal Science and Practice 2019; 42: 67-83
• 21 Abboud J, Marchand AA, Sorra K. et al Musculoskeletal physical outcome measures in individuals with tension-type headache: a scoping review. Cephalalgia 2013; 33: 1319-1336
• 22 Ailani J, Burch RC, Robbins MS. et al The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice. Headache 2021; 61: 1021-1039
• 23 Diener H-C, Förderreuther S, Kropp P. et al Therapie der Migräneattacke und Prophylaxe der Migräne, S1-Leitlinie, 2022, DGN und DMKG. In: Deutsche Gesellschaft für Neurologie (Hrsg.) Leitlinien für Diagnostik und Therapie in der Neurologie. Berlin 2022
• 24 Bendtsen L, Evers S, Linde M. et al EFNS guideline on the treatment of tension-type headache – report of an EFNS task force. Eur J Neurol 2010; 17: 1318-1325
• 25 Straube A. et al Therapie des episodischen und chronischen Kopfschmerzes vom Spannungstyp und anderer chronischer täglicher Kopfschmerzen. S1 Leitlinie. AWMF-Registernummer: 030/077 2015
• 26 Herranz-Gómez A, García-Pascual I, Montero-Iniesta P. et al Effectiveness of Exercise and Manual Therapy as Treatment for Patients with Migraine, Tension-Type Headache or Cervicogenic Headache: An Umbrella and Mapping Review with Meta-Meta-Analysis. Applied Sciences 2021; 11: 6856
• 27 Varangot-Reille C, Suso-Martí L, Dubuis V. et al Exercise and Manual Therapy for the Treatment of Primary Headache: An Umbrella and Mapping Review. Phys Ther 2022
• 28 Jung Eschke R-C, Gabler T. et al Effectiveness of physiotherapeutic treatment interventions on pain intensity, duration, frequency, and quality of life of patients with migraine: a systematic review. Der Schmerz 2021: 1-11
• 29 Woldeamanuel YW, Oliveira ABD. What is the efficacy of aerobic exercise versus strength training in the treatment of migraine? A systematic review and network meta-analysis of clinical trials. J Headache Pain 2022; 23: 134
• 30 Jung Eschke RC, Struss J. et al Effectiveness of physiotherapy interventions on headache intensity, frequency, duration and quality of life of patients with tension-type headache. A systematic review and network meta-analysis. Cephalalgia 2022: 3331024221082073
• 31 Kamonseki DH, Lopes EP, van der Meer HA. et al Effectiveness of manual therapy in patients with tension-type headache. A systematic review and meta-analysis. Disabil Rehabil 2022; 44: 1780-1789
• 32 Krøll LS, Callesen HE, Carlsen LN. et al Manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education for patients with tension-type headache. A systematic review and meta-analysis. J Headache Pain 2021; 22: 96
• 33 Irby MB, Bond DS, Lipton RB. et al Aerobic Exercise for Reducing Migraine Burden: Mechanisms, Markers, and Models of Change Processes. Headache 2016; 56: 357-369
• 34 Pellegrino ABW, Davis-Martin RE, Houle TT. et al Perceived triggers of primary headache disorders: A meta-analysis. Cephalalgia 2018; 38: 1188-1198
• 35 Luedtke K, Starke W, Korn K. et al Neck treatment compared to aerobic exercise in migraine: A preference-based clinical trial. Cephalalgia Reports 2020; 03: 2515816320930681
• 36 Hagan KK, Li W, Mostofsky E. et al Prospective cohort study of routine exercise and headache outcomes among adults with episodic migraine. Headache 2021; 61: 493-499
• 37 Annalisa G, Davide B, Marco A. Sport and migraine-a dynamic relationship. Neurol Sci 2022; 43: 5749-5751
• 38 Amin FM, Aristeidou S, Baraldi C. et al The association between migraine and physical exercise. J Headache Pain 2018; 19: 83
• 39 Pi C, Liu Y, Li L. et al Effects on neuromodulation, acupuncture, and aerobic exercises on migraine and tension-type headache outcomes: A systematic review and meta-analysis. Medicine (Baltimore) 2022; 101: e30530
• 40 Varangot-Reille C, Suso-Martí L, Romero-Palau M. et al Effects of Different Therapeutic Exercise Modalities on Migraine or Tension-Type Headache: A Systematic Review and Meta-Analysis with a Replicability Analysis. J Pain 2022; 23: 1099-1122
• 41 Meise R, Schwarz A, Luedtke K. Effectiveness of Patient Education and Cognitive Behavioural Treatment as a Non-Pharmacological Intervention for Migraine in Adults – A Systematic Review. SN Comprehensive Clinical Medicine 2022; 04: 197
• 42 Seng EK, Martin PR, Houle TT. Lifestyle factors and migraine. Lancet Neurol 2022; 21: 911-921
• 43 Nazari F, Safavi M, Mahmudi M. Migraine and its relation with lifestyle in women. Pain Pract 2010; 10: 228-234
• 44 Casanova A, Vives-Mestres M, Donoghue S. et al The role of avoiding known triggers, embracing protectors, and adhering to healthy lifestyle recommendations in migraine prophylaxis: Insights from a prospective cohort of 1125 people with episodic migraine. Headache 2023; 63: 51-61
• 45 Meise R, Carvalho GF, Thiel C. et al Additional effects of pain neuroscience education combined with physiotherapy on the headache frequency of adult patients with migraine: A randomized controlled trial. Cephalalgia 2023; 43: 3331024221144781
• 46 Mosley GL, Butler DS. Explain pain supercharged. J Chiropr Educ 2019; 33: 49-50