The Benefits of Cranial Therapy on Headaches

Author: Faye H. McDew-Carrington PT

Abstract: This case study describes the utilization of Cranial Therapy and Integrative Manual Therapy provided to address and resolve the complaints of a 37 year old female who reported chronic headaches for a 14 year duration usually associated with her menses. The patient reported that the headaches last approximately 3 days prior to the onset of her menses and often extend into the left trapezius region.

Key Words: Headache, Cranial Therapy, Menses

History

Upon intake, the patient reported occipital pain usually occurring for 3 days and often lasting for the 3 days prior to her menses. This patient had sought relief of the pain in the past with chiropractic adjustments and the use of advil. She described the pain as moderate to severe in nature and would often necessitate being in a dark, quiet room for a day or two for relief in addition to the over the counter medication to resolve the headache. The patient also has a history of sinus headaches and congestion, which is reportedly treated with prescription medication. The patient is a 37 year old left hand dominant female homemaker with 3 small children who reports that stress and pork make her symptoms worse. Sensory changes are denied in the left upper extremity.

Evaluation

Upon initial assessment, the static standing posture revealed a mild forward head, a decreased thoracic kyphosis and slightly decreased lumbar lordosis as noted in the sagittal plane. Within the coronal plane there was moderate postural asymmetry with elevation of the left ear and left scapula, a decrease in shoulder levels left lower than right, and a pelvic obliquity right greater than left. A mild right thoracic scoliosis is noted with a forward left shoulder and ASIS within the transverse plane. Cervical range of motion was remarkable for the complaint of pain in the directions of left rotation, extension and side bending right. There was moderate spasm of the left scalene and upper trap musculature upon palpation. There was a difference in the appearance of the left eye aperture versus the right with the left eye smaller than the right. Deep tendon reflexes were absent at left biceps, right and left triceps, reduced at the right and left brachioradialis and within normal limits at the right biceps. There was a decrease in gross motor strength of the left upper extremity versus right proximally.

Treatment

The patient appeared an excellent candidate for Integrative Manual Therapy and was initiated upon:

• Cranial Therapy Type I (side bending and rotation occur to the opposite side) for the parietals, frontals, occiput, zygoma, maxilla and mandible.
• Bone Bruises were detected at frontal, zygomata right and left, left sphenoid left orbit, parietal, sphenobasilar and were addressed using the Bone Bruise Technique.
• Cranial Therapy Type 2 dysfunction of the sphenoid (side bending and rotation occur to the same side) were also provided during the course of treatment.
• The patient also received Cranial Therapy Osseous Release of the cranial bones as well as Bone Compression and Distraction Techniques and Dural Release.
• Treatment of the lamilla including type 2 dysfunctions as well as Compression Syndromes for the cranial diaphragm, was provided.
• The patient was treated with Lung Synchronizer #14 and a protocol for Dural Craniosacral Rhythm.
• Immune Deficiency Motility was detected at the maxillary, and ethmoid sinuses and addressed using Integrative Manual Therapy techniques.

Outcome

The patient was treated 2 times a week from August 2000 thru October 2000 and then on a weekly basis intermittently from November 2000 thru January 2001 with marked improvement in neck flexibility, which was unremarkable for the complaint of pain. The severity of occipital headaches prior to her menses was reduced significantly as well as sinus headaches that occurred intermittently. In addition, there was a change in the deep tendon reflexes at biceps and brachioradialis on the left and brachioradialis on the right they all became within normal limits. There was an overall reduction in tonus palpated at the left lateral neck musculature.

Conclusion

The patient who received Integrative Manual Therapy reported subjectively overall improvement in the frequency of occipital headaches associated with her menses as well as the intensity of said headaches. There was an improvement in neck flexibility in all directions of approximately 75-50% without resultant complaint of left upper quadrant pain. Deep tendon reflexes were also improved upon reassessment bilaterally. The patient reported a decrease in the use of pain medications and sinus medications once required previously to provide relief of occipital as well as sinus headaches. This study concludes with the benefit of Integrative Manual Therapy in overall pain and dysfunction of a 37 year old female.

References

1. Law 1 Fryettes Law of Motion, Weiselfish S., Manual Therapy with Muscle Energy Technique, ANA Publishing, West Hartford, CT, 1994, p77.

2. Miller M., Osbourne J., Gordon W., Hinkin D., Binker M.,: The Natural History of Bone Bruises, America Journal of Sports Medicine, Vol 26, November 1, 1998, American Orthopedic Society for Sports Medicine.

3. Type 2 law 2 Fyettes Law of Motion. Weiselfish S., Manual therapy with Muscle Energy Technique, ANA Publishing, West Hartford, CT, 1992, p 77.

4. Ditto (as above)

5. Information from S. Weiselfish

6. Information from S. Weiselfish

7. Information from S. Weiselfish