Headache Caused by Arthritis of the Cervical Spine

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Arthritis and its allied conditions, (myositis, fibrositis, fascitis and tenosynovitis, involving the bones and attachments of the cervical spine and base of the skull) produce a type of cephalalgia that often causes considerable diagnostic and therapeutic difficulties. This form of headache occurs almost as frequently as ocular and migraine headaches but it has not been appreciated to the same extent because it is attributed so often to other etiological factors. Diagnosis must be made largely from the history. Fortunately, this is quite characteristic in most cases and is as typically diagnostic as the true migraine syndrome.

The headache invariably begins in the occiput but has a tendency to spread upwards and forward into the temporal regions as it becomes more severe. If the patient is able to critically analyze the onset, the pain will really be placed in the cervical muscles with a feeling of stiffness and soreness, especially of the attachment of the trapezius muscle to the skull. Of extreme diagnostic importance is the tenderness of this tendon attachment. The headaches occur periodically at first, lasting three to four days, a trifle longer than the usual migraine headache. There is a tendency to have long sieges of constant headache which may become a permanent daily headache. In a great majority of patients the headache comes on early in the morning and usually wakens them from sleep.

Most patients notice the relation of the headache to exposure to drafts, such as riding in the back seat of a car, sitting. . .



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