This hands-on 2-day (15 hr) course will provide participants with an Evidence Based Approach to the evaluation and treatment of the headache patient, particularly tension type and cervicogenic headache. It will include a comprehensive presentation on the most updated findings related to sensory and motor impairments in these two headaches demonstrated from researchers from Australia, particularly Gwen Jull from the University of Queensland, and from Spain, particularly the teacher of the seminar, César Fernández-de-las-Peñas. These studies have shown the role of muscle and joints, and impairments in the motor control strategy which has set the stage for a multisystem approach to the evaluation, treatment and management of patients with headache.
New models including neurophysiological changes in the nociceptive system and descending inhibitory systems will be covered. Recent evidence is also showing the presence of cortical changes in the brainstem of patients with headache, probably due to the pain. The research and efficacy of manual therapies is phenomenal. Come and find out why “muscle and joint tissues” will work in the long run, integrating their inputs into the brainstem. You may have already heard about muscle trigger points or neural mechano-sensitivity and perhaps you’ve read about the importance of the cervical and thoracic spines in headache. This course will bring all the elements together in a way that will make anatomical, biomechanical, neurophysiological and, more importantly, clinically applicable sense. Learn how to assess for joint and muscle tissue dysfunction and pain inhibition with repercussion on the “pain neuromatrix” of the brainstem.
- Track and critically appraise best evidence currently available on the clinical treatment of tension type headache, cervicogenic headache and migraine.
- Perform clear and concise subjective evaluations of patients presenting with headache
- Generate working hypotheses of patient’s problem related to the structures involved, the presentation and the behavior of the pain condition, and the functional repercussion on subject lifestyle
- Plan and conduct objective examinations of the structures implicated by the working hypothesis.
- Plan optimal courses of treatment using orthopedic manual therapy techniques, with special emphasis on neurophysiological aspects of the “pain neuromatrix”.
- Demonstrate clinical application of muscle, joint and neural approaches with emphasis into adaptations into the “pain neuromatrix” of the brainstem
9:00 – 9:15. Welcome & Intro
9:15 – 9:45. The problem of headache: symptoms or illness? The pain neuromatrix
9:45 – 10:15. Clinical presentation of tension type, cervicogenic and migraine headache
10:15 – 11:15. Peripheral and central sensitization mechanisms in headaches
11:15 – 11:30. Break
11:30 – 12:00. Cervical and thoracic spine and head pain: An Evidence-Based Approach
12:00 – 13:30. Lab: Manual exploration of cervical spine dysfunction
13:30 – 14:30. Lunch
14:30 – 15:00. Manual therapy for cervical-thoracic spine: Evidence-Based Approach
15:00 – 16:30. Lab: Joint mobilization/manipulation of the cervical and thoracic spine
16:30 – 16:45. Break
16:45 – 18:00. Lab: Joint mobilization/manipulation of the cervical and thoracic spine
9:00 – 9:15. Review and Q
9:15 – 9:45. Myofascial pain syndrome as potential source of referred pain to the head: Research in headache
9:45 – 10:30. Clinical and neurophysiological presentation of trigger points: Evidence-Based Approach
10:30 – 10:45. Break
10:45 – 12:00. Lab: Clinical examinations of muscle trigger points of the head and neck
12:00 – 12:30. Management of trigger points for headache: Evidence-Based Approach
12:30 – 14:00. Lab: Manual therapies for head and neck muscle trigger points
14.00 – 14:15. Summary and Questions
About the course leader
Dr. César Fernández-de-las-Peñas received his Degree in Physical Therapy from Universidad Rey Juan Carlos, Spain in 2000. He received a Post-Graduate Diploma in Spinal Manipulative Therapy (6 years) and Osteopathy (DO) from the Scientific European Osteopathic Society in 2005-06. He also received a Post-Graduate Diploma in Myofascial Pain Syndrome from the Universidad Castilla-La-Mancha in 2003. He reached his first PhD degree in Biomedical Sciences in 2007 at the Sensory-Motor Interaction Centre (SMI) in Aalborg University (Denmark) under the supervision of Prof. Lars Arendt-Nielsen. He also finished a second PhD degree in 2008 at the Universidad Rey Juan Carlos.
Dr. Fernández-de-las-Peñas currently works as clinical researcher and teacher at the Universidad Rey Juan Carlos since 2001 and he is the Head Division of the Pain Laboratory and the Department of Physical Therapy of the same University. He also works in private practice specialized in chronic pain from 2000 in Madrid, Spain. He began his physical therapy career in sport elite and rheumatology rehabilitation. In 2001 he began in an outpatient clinic focused on pain, particularly in fibromyalgia syndrome, neck and low back pain. He has published around 200 publications and he is the first author of approximately 100 of them.
The most relevant topics of his research are focused on neck pain, headache, lateral epicondylalgia, carpal tunnel syndrome, fibromyalgia syndrome and neuro-physiological effects of manual therapy. His clinical research is mainly concentrated on biomedical sciences within neuroscience. The specific research areas have been on pain and assessment of chronic pain. He has participated in 60 conferences with related published proceedings and has given several lectures at national and international meetings/workshops /seminars.