Facial pain, cervical pain, and headache.

PURPOSE OF REVIEW This review discusses the role of musculoskeletal structures of the jaw and neck in perpetuating or triggering primary headache. Because treatments aimed at these structures often reduce headache, a better understanding of their role in headache is needed. RECENT FINDINGS Central sensitization may result in changes in the afferent pathways, making communication from cervical and temporomandibular nociceptive neurons to the trigeminal nucleus possible. This provides the pathophysiologic basis for directing therapy to the neck or temporomandibular joint to alleviate primary headache. SUMMARY Clinicians should recognize the significant role that musculoskeletal structures of the head and neck play in the perpetuation of headache and the importance of evaluating every patient for temporomandibular disorders and cervical abnormalities.