What to Look Out for, What to Do, and When: 3 Key Messages for Safely Treating Neck Pain, Headache, and/or Orofacial Symptoms in Musculoskeletal Rehabilitation Settings

Neck pain, headache, and/ or orofacial symptoms are potentially the first (nonischemic) symptoms of an underlying vascular pathology or blood flow limitation. If an underly-ing vascular pathology or blood flow limitation is not recognized by the musculoskeletal rehabilita-tion clinician, it can subsequently be aggravated by treatment, raising the risk of serious adverse events. We argue that clinicians can make an important, and potentially lifesaving, difference by providing specific information and advice. This is especially the case in patients with an intermediate level of concern, for example, in patients who only show a few concerning features regarding a possible underlying serious condition and for whom an initial vasculogenic hypothesis was rejected during the clinical reasoning process. We present back-ground information to help the reader understand the context of the problem and suggestions for how clinicians can provide appropriate informa-tion and advice to patients who present with neck pain, headache, and/or orofacial symptoms.