• Johnson J
• McQueen M
• Gogineni V
• Kirk E

• Adolescent
• Female
• Headache
• Open Access Document

Objective: Headache disorders are the third leading cause of disability worldwide and result in substantial health care utilization. This case highlights the care pathway of a patient with a new onset of uninterrupted cervicogenic headaches, the resulting health care utilization, and cost associated with chiropractic care.

Clinical Features: A 15-year-old female with a new onset of uninterrupted headaches over the previous 2-months with associated visual disturbances, nausea, and dizziness was referred to chiropractic care. Prior to receiving a referral, she was evaluated by five different health care providers and received a magnetic resonance image of the brain. These investigations did not identify any structural abnormalities or relevant psychosocial factors.

Intervention and Outcome: On initial examination, presence of active bilateral trigger points of the suboccipital muscles and spinal joint restrictions were identified. A treatment plan consisting of myofascial release of the suboccipital muscles, chiropractic manipulation of the cervical and thoracic spine, and a home exercise plan of suboccipital stretching was implemented. Two additional treatment sessions at 1-week intervals resulted in full symptom resolution and discharge from care. After a 2-year follow-up period, billing data throughout the patient’s care pathway associated with this headache episode and four recurrent episodes was obtained. The data collected showed that the entirety of this patient’s chiropractic care over a 2-year period cost substantially less than the portion of health care services utilized during the 2-months prior to establishing chiropractic care.

Conclusion: This case demonstrates the potential for reducing health care utilization and spending by establishing chiropractic care early in the management pathway for headaches. It is well-established that there is a reduction in health care utilization and spending when patients establish care with chiropractors or physical therapists first for low back pain complaints. However, there is insufficient data available for headaches. Further investigation to identify if there is an association between initiating care with chiropractors for headaches and a reduction in health care utilization is warranted.

Author keywords: Health Care Utilization; Headaches; Chiropractic

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