Objective: To discuss chiropractic management of a patient with chronic migraine.
Clinical Features: A 24-year-old female had a history of chronic headaches. She also exhibited photophobia, nausea, vagal nerve dysfunction, left arm paresthesia and significant sleep disruption. In addition, she had a history of psoriasis, anxiety, and depression. She was offered long-term pharmacologic management but declined due to her concerns about side-effect. She was referred by her primary-care provider for chiropractic care involving upper cervical technique. At her first visit she had Visual Analog Scale score of 9/10 and Neck Disability index score of 24/50.
Intervention and Outcomes: She completed a care plan receiving care 3 times a week for 2 weeks, 2 times a week for 2 weeks, once a week for 5 weeks, and then every other week for 4 weeks. During each visit, she received a Toggle evaluation, and when appropriate, she received a Toggle adjustment in the cervical region. She also received either ultrasound and red-light therapy each visit. Migraine frequency was reduced from 3 times a week to 2 times a month. VAS scores improved from 9/10 to 5/10, and the Neck Disability Index decreased from 24/50 to 16/50 after the 4th week. After 12 weeks, her migraines were limited to 1 episode per month. Her Visual Analog Scale fell even more, from 5/10 to 3/10, and her Neck Disability Index decreased from 16/50 to 10/50.
Conclusion: Chiropractic care with the Toggle technique and other rehabilitation options may provide a safe, conservative option for migraine management. This suggests the need for more research and controlled studies in how chiropractic care combined with other rehabilitation options may help patients’ symptoms of migraine headaches.
Author keywords: Chiropractic; Migraine
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