Headache & Orofacial Pain: A traffic-light prognosis approach

 

Patients with HA commonly present MSK impairmentsand therefore are treated by MSK clinicians, with variable outcomes. To maximize the positive response and outcome, a new practical prognosis-based framework is suggested in this perspective article.
Traffic Light Prognosis

TL diagram

Greenbaum and Emodi-Perlman 2023.

According to this framework, patients with HA should be categorized into four traffic-light colors: red, green, yellow, and orange. The meaning of each color is the expected prognosis of the patient by receiving the relevant MSK intervention (cranio-cervical and/or cranio-mandibular).

“Red” patients are those who present signs and symptoms ofdangerous HA and therefore should be referred immediately for further emergency medical evaluation and management.  “Green” patients are those who present pure MSK HA (CGH and HA attributed to the TMDs) and, therefore, should receivethe appropriate MSK management with an excellent prognosis.

“Yellow” patients presenting primary HA with significantmeasurable MSK impairments should be treated by the MSK clinician with a certain degree of an expected positive prognosis.  Finally, “Orange” patients are those with primary HA without measurable MSK impairments and, therefore, are not likely to benefit from MSK interventions.