Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case control study

ABSTRACT

Objectives: Headaches can be associated with rhinosinusitis and may present a diagnostic challenge because of symptomatic overlap with other recurring headaches. Neck pain has received extensive attention in migraine, tension-type and cervicogenic headache but not as a comorbid feature of headache in those with rhinosinusitis. This study investigated the occurrence of neck pain and cervical musculoskeletal dysfunction in individuals with self-reported sinus headaches (SRSH).

Methods: Participants with and without SRSH attended a single data collection session. Participants completed the Headache Impact Test (HIT)-6 and the Sino-Nasal Outcome Test (SNOT)-22. Cervical range of motion (ROM), segmental examination, muscle endurance and pressure-pain threshold (PPT) were measured .

Results: Participants included 31 with SRSH (77.4% female; age 43.7 (9.9) years) and 30 without headache. Average symptom duration was 89.7 (±85.6) months. Mean SNOT-22 and HIT-6 scores were 36.2 (15.3) and 56.7 (7.1), respectively. In the SRSH group, 83.9% (n = 26) reported neck pain. There was a significant difference between groups for cervical sagittal (14.3° [5.3°, 23.3°], p = 0.002) and transverse plane ROM (21.5° [12.4°, 30.6°], p < 0.001), but no difference in frontal plane motion (p = 0.017). There were significant between groups difference in neck flexor endurance (19.5 s [10.1 s, 28.9 s], <0.001), segmental dysfunction O-C4 (p < 0.001) but not in PPT (p = 0.04).

Discussion: Neck pain and cervical musculoskeletal dysfunction are common among persons with SRSH and may be a comorbid feature or contributing factor to headaches attributed to rhinosinusitis. Further research is needed to understand these associations.

KEYWORDS:

• Sinus
• rhinosinusitis
• headache
• neck pain
• range of motion
• muscle strength

Acknowledgments

We would like to acknowledge Laura Burton, Daniel Larson and Christopher Postma for assistance with data collection.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval

Ethical clearance was gained from the Des Moines University Institutional Review Board IRB-10-15-02.

Data availability statement

The data collected and analyzed during this study is available through the corresponding author upon reasonable request.

Additional information

Funding

This work was supported by the Des Moines University Iowa Osteopathic Education Research and Grants under Grant 112-3126.

Notes on contributors

Shannon M. Petersen

Shannon M. Petersen, DScPT, OCS, FAAOMPT is a Professor of Physical Therapy at Des Moines University, Des Moines, Iowa. She completed her post-professional doctorate at Andrews University and post-doctoral fellowship in orthopedic manual physical therapy at Regis University. Dr. Petersen is a certified orthopedic clinical specialist in physical therapy and a Fellow in the American Academy of Orthopedic Manual Physical Therapists.

Gwendolen A. Jull

Gwendolen A. Jull, AO, MPhty, PhD, FACP is an Emeritus Professor in Physiotherapy in the School of Health and Rehabilitation Sciences at the University of Queensland, Australia. She completed her PhD at the University of Queensland and a Fellowship of the Australian College of Physiotherapists in the clinical specialty area of Musculoskeletal Physiotherapy.

Kenneth E. Learman

Kenneth E. Learman, PT, PhD is a Professor of Physical Therapy at Youngstown State University in Youngstown, Ohio. He received his BSPT at SUNY- Buffalo, his MEd in Health Education at Penn State University and his PhD in Sports Medicine at the University of Pittsburgh. In addition, Ken is a board certification specialist in orthopedic physical therapy, a certified orthopedic manual therapist through Maitland-Australian Physiotherapy Seminars (MAPS), and a fellow in the American Academy of Orthopedic Manual Physical Therapists.