Headaches are a symptom experienced by an estimated 45 million Americans and lead to more than 18 million office visits a year in the United States.1,2 Headaches are also the number one cause for Americans to take over-the-counter analgesic medications.2 Headaches can be classified as 1) Migraine Without Aura (Common Migraine), 2) Migraine With Aura (Classic Migraine), 3) Tension Type Headaches (Musculoskelatal), 4) Tension-Migraine (Mixed Headache Disorder), 5) Recurring Headaches of a Nonmusculoskeletal nature and 6) Headaches as a Symptom of Ominous Disease.1 The cause and successful treatment vary greatly for migraine headaches and such headaches are often referred to and treated by a physician.1 When the patient chooses treatment outside of the medical model it is most often a chiropractor who is chosen as the care provider.2
The true nature of headaches and the proper treatment for them has been reported on so widely that a number of treatment techniques have emerged. Nonthrust manipulation is done by Physical Therapists in musculoskelatal type headaches with reported improvement.1 Spinal manipulation under anesthesia is reported as being used as early as the 1930's and 1940's. This was performed and documented mostly by medical and osteopathic physicians and was used with the idea that fibrous adhesions had formed within joint capsule. While the medical and osteopathic professions have abandoned this in favor of pharmacology and surgery, chiropractors have continued the research and continue to find success.3 Other professionals have found psychological treatment to have a positive effect on chronic headaches, in particular by reducing the frequency of the pain.5 The Chiropractic upper cervical adjustments have also proven to relieve cervicogenic and musculoskelatal headaches by removing interference so close to the brain.2 Some patients, as this case will illustrate, have found relief from upper thoracic adjustments after receiving no relief from cervical adjustments.
In the following case, a headache of mechanical origin was unsuccessfully treated with upper cervical adjustments to the Occiput/C1 and the C1/C2 joint couples, but successfully treated with a short-lever, high-amplitude, low-force chiropractic adjustment to the upper thoracic spine, specifically the first thoracic.
The patient was a 23-year-old Caucasian male who was a student at Palmer College of Chiropractic. He had been a student between four and six months when he experienced his first headache. It occurred after a week of exams, which he reported studying for an average 4 hours per night for five consecutive nights. The patient presented three days after the symptoms began and no relief had been experienced. He complained of constant suboccipital pain that worsened with flexion or extension of the cervical spine. His symptoms were better in the morning, but worsened as the day progressed and lessened...