The usefulness of testing head and neck muscle tenderness and neck mobility in acute headache patients.

The aim of this study was to investigate the diagnostic value of pericranial muscle tenderness (PT) and neck mobility assessment in differentiating primary from secondary headache in patients with acute headache, when life-threatening conditions like subarachnoid haemorrhage (SAH) and meningitis have been ruled out. Two neurologists made diagnoses independently, placing patients in either a primary or a secondary headache group. Patients without SAH or meningitis were examined for PT and neck mobility by a single examiner. Headache-free patients acted as controls. We found no significant difference in PT between primary and secondary headache patients, or between secondary headache patients and controls. There were no significant differences in neck mobility between any groups. Our findings suggest that assessment of PT and neck mobility does not help to distinguish acute primary from secondary headaches when SAH and meningitis have been excluded.