Musculoskeletal head and neck pain

Musculoskeletal head and neck pain is an extremely common clinical syndrome in outpatient pain practice. Cervical structures are a frequent cause of headache and must be differentiated from primary headache disorders. Convergence of cervical and trigeminal nociceptive pathways in the upper part of the cervical spinal cord is the neurophysiologic basis of this connection. An interdisciplinary pain management approach that addresses psychosocial factors, pharmacologic and interventional pain management and incorporates progressive exercise training is most likely to be effective. This review discusses the comprehensive evaluation and management of musculoskeletal head and neck pain with a focus on cervicogenic headache, cervical myofascial pain, and temperomandibular dysfunction.