Tension-Type and Cervicogenic Headache; Pathophysiology, Diagnosis and Management.
Article Type: Book review
Subject: Books (Book reviews)
Author: Tse, Nikki
Pub Date: 03/01/2010
Publication: Name: New Zealand Journal of Physiotherapy Publisher: New Zealand Society of Physiotherapists Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 New Zealand Society of Physiotherapists ISSN: 0303-7193
Issue: Date: March, 2010 Source Volume: 38 Source Issue: 1
Topic: NamedWork: Tension-Type and Cervicogenic Headache; Pathophysiology, Diagnosis and Management (Nonfiction work)
Persons: Reviewee: Fernandez-De-Las Penas, C.; Arendt-Nielsen, L.; Gerwin, R.
Accession Number: 226728751
Full Text: Tension-Type and Cervicogenic Headache; Pathophysiology, Diagnosis and Management. C. Fernandez-De-Las Penas, L. Arendt-Nielsen and R. Gerwin, R. (eds). 2010. Jones and Barlett Publishers, Sudbury. ISBN 978-0-7637-5283-5. Hard Cover. 501 pages. NZD 124.13

This textbook is part of Jones and Bartlett's series on Contemporary Issues in Physical Therapy and Rehabilitation Medicine. Contributors are physiotherapists, doctors, researchers, a dentist and osteopaths from Australia, North America and Europe and are generally acknowledged experts in the area of TTH or CeH. The text is intended for health professionals involved in diagnosis and management of headache patients. It serves the intended purpose well with in-depth discussion and review of the science and clinical aspects of TTH and CeH and is well situated amongst other similar books. Unlike the book by Gwen Jull on Whiplash, Headache and Neck Pain, which only reviews research of their Queensland-based, research centre, this is more wide ranging with each chapter reviewing the author's own research and relevant references from others on the topic.

The book is very comprehensive and is divided into sections: Part 1 reviews epidemiology and the medical approach to history and examination. Part 2 discusses the pathophysiology of TTH, including excellent chapters on muscle pain, referred pain and pain sensitisation. Part 3, looks at the pathophysiology of CeH, including the trigeminocervical complex, pathogenesis and motor control impairment. Part 4 covers physical examination, including the orofacial area. Part 5 examines neurophysiological effects of some treatment methods. Part 6 reviews conservative management of TTH and CeH. The last part translates theory into practice, with a case study of a chronic daily headache patient, which helps tie everything together. In most chapters, good quality diagrams, photographs, figures and tables complement the text.

In general, the first five parts are an excellent, in depth and up to date review of the latest evidence base, for assessment and treatment of TTH and CeH, and the neurophysiological effects of some interventions. Unfortunately, where the book let its standards slip was in the Management section where, because of having multiple contributors from different clinical areas, not all chapters are consistently written. While most authors have referenced up to date evidence where available, the chapters on Muscle Energy Techniques (MET), Neuromuscular Approaches and Myofascial Induction have very little evidence presented for the techniques. The section on MET states that there are "... no studies on MET involving muscles in the Cervical Spine region and only very few studies on its effectiveness in cervical spine dysfunction...", so it is difficult to see from an evidence based practice point of view, why this chapter was even included.

I also have concerns about the appropriateness of including chapters which clearly demonstrate how to mobilise and manipulate the cervical spine, yet do not cover contraindications and precautions, or symptoms of instability, vertebrobasilar insufficiency (VBI) and how and why it is important to test for these, especially in a headache population. Some techniques described use combined end range rotation with traction or extension, which is not recommended by the APA (Australian Physiotherapy Association) Guidelines for Manipulation of the Cervical Spine (also adopted by the NZSP and NZMPA). While it may be acceptable for Osteopaths or Chiropractors to perform these techniques without assessing for VBI, it would not be for NZ or Australian physiotherapists. It is a shame that the same physiotherapists (Vicenzino, B. et. al) who wrote the chapter on the Neurophysiologic Effects of Manipulation, didn't also write the management chapter.

Generally the textbook is highly relevant to NZ physiotherapists and would be a useful reference and revision for qualified practitioners working in this area or undergraduate physiotherapy students who would like to learn more about TTH and CeH (as long as the manual and manipulative therapy techniques are not used).

Nikki Tse, MHP (First Class Hons) (Musculoskeletal Physio), PGDHSc (Western Acupuncture) Principal Physiotherapist About Faces Physiotherapy Auckland
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