OBJECTIVE: To discuss the case of a patient suffering from severe headache complaints who was previously unresponsive to regional cervical spine care.

CLINICAL FEATURES: A prodrome was described. In addition to headache itself, associated symptoms included light sensitivity, blurred vision and nausea. A visit to a hospital emergency room was often necessary to reduce pain intensity.

INTERVENTION AND OUTCOMES: Manual chiropractic spinal adjustment were performed as the only treatment intervention. After a course of treatment, the patient reported no visits to the emergency room, even after a 1-yr follow-up, and the average visual analogue pain scores decreased.

CONCLUSION: This patient seemed to respond favorably to conservative care that included regions of spine not traditionally associated with headache pain. This suggests that some individuals may require a more comprehensive evaluation if regional care fails to promote a positive response within a few weeks. Controlled, randomized trials will assist in comparing effectiveness of various treatment interventions.

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