Chiropractic/rehabilitative management of chronic headaches: A retrospective case report

To discusses management of cervicogenic headache by chiropractic manipulation and an active rehabilitation program.

A 28-year-old female had headaches of approximately a 10-year duration that were located on the right occipital-cervical region with radiation into the right paraspinal musculature of the cervical spine. Prior allopathic intervention included pharmaceutical approaches without resolution of symptoms. The area involved demonstrated marked point tenderness to static/motion palpation techniques. Manual resisted muscle testing of the sub-occpitals, upper trapezious, levator scapulae and the rhomboids decreased her pain, while testing of the anterior scalenes and sternocleidomastoids muscles created an increase in her pain. Seated cervical spine range of motion was diminished in all ranges and was limited by an increase in her pain of the right sub-occipital joint. The remainder of the examination was unremarkable.

Treatment plan and intervention included patient education in posture and an in-office treatment program progressing to home therapy was reviewed with the patient. She noticed an increase in signs and symptoms after her first 3 visits followed by a decrease in her primary signs and symptoms during visits 3-5. An in-office active rehabilitation program was included with a continued positive response. She was released to home therapy and supportive chiropractic manipulation with continued positive response.

Management of cervicogenic headaches with chiropractic manipulation and rehabilitation is discussed. A literature review is included. Past trauma with altered postural biomechanics appeared to be the cause in this particular case. Management strategies including education of proper biomechanics, rehabilitation and chiropractic manipulation were effective in this case.