Finding the root cause of your headaches: A Case Study

10 May Finding the root cause of your headaches: A Case Study

As discussed in a previous blog, there are 3 main types of headache (Migraine, Tension & Cervicogenic) of which Cervicogenic headache is the most responsive to manual therapy, exercise and posture correction.

Cervicogenic headaches, a result of neck pathology, may be exacerbated by:

• referred pain from the muscles and joints in the jaw,
• sustained head position (e.g. head turned to talk to a friend),
• spinal scoliosis,
• poor posture when sitting in a car, lounge chair or working at a computer, and
• muscle tension from emotional anxiety.

In fact, neck pathology can have detrimental effects on numerous areas. Today, Ian demonstrates this via a recent patient case study.

Patient Presentation and Assessment:

The patient presented to our clinic for treatment of her shoulder after a fall. She had suffered from chronic neck pain, stiffness, and headaches following a whiplash injury 25 years ago. Initially, after her whiplash injury, she had received no physiotherapy management for her neck; she had been warned away from any form of treatment from her GP.

Due to the possibility that the shoulder problem was due to referred pain from the neck combined with a history of a pre-existing neck problem, the neck was assessed first.

A physiotherapy assessment of the neck consists of observing posture and active neck movements as well as feeling the integrity of both the joints and muscles of the neck. In this case:

• posture demonstrated that the head was sticking forward, and the shoulders were at different heights
• correcting posture then assessing neck movement demonstrated improvement in both neck and shoulder movement 
• assessing the joints and muscles of the neck reproduced both the shoulder pain and the headaches that had been affecting the client since her whiplash injury thus demonstrating that the neck was responsible for both issues.

The patient was amazed that the neck was causing both her headaches and shoulder problems and that treating the one body part (the neck) provided relief of both problems.

Results:

• The shoulder pain resolved much faster than the neck pain, which is very common when a problem has persisted for such a long time (in this case 25+ years).
• The neck problem required several months of manual therapy and daily exercises to reduce the frequency, intensity and duration of the headaches. 

The salient point of this case study is the impact of a long-standing unresolved problem upon a new and apparently unrelated injury to an adjacent body part. When your physiotherapist is assessing an adjacent or apparently unrelated body part, there is usually a very good clinical reason for doing so!

Don’t let your past injuries hold you back any longer – come in today to see one of our experienced physiotherapists for a full body assessment.