Case Study:

Treating Chronic Headaches with Basic Techniques of Integrative Manual Therapy

Author:  Ronit Gil’ad, B.P.T.

Abstract:  Headaches are one of the more common complaints of people all over the world.  This case study is about a 38 year old female who has suffered from headaches since childhood, approximately 25 days out of every month.  Indeed, only basic Integrative Manual Therapy techniques have been utilized to treat her.  It was to her great satisfaction, although not with complete relief.  This case study will show the great benefit of Integrative Manual Therapy techniques, even basic ones, in treating this common complaint of headaches.

Key Words:  Headaches, Integrative Manual Therapy, Menses, Neurofascial Processing (NFP), Transverse Mapping, Cranial Therapy, and Lamilla.

History:  R.D. is a 38 year old female computer worker who came to therapy with complaints of headaches since her childhood.  She estimated that the headaches appeared about 25 out of 30 days of every month.  Those headaches increased during and after stress, lack of sleep, and before her menses.  She took 5 different sorts of OTC analgesic drugs, beginning each day with 1-2 doses of Optalgin.  All the drugs she had taken helped only to decrease the pain, but did not stop it.  Every headache lasts for 1-3 days.  She described the nature of the headache as a sense of stress which began in the occipital area, and gradually increased and spread towards the right frontal area, sometimes toward the right cheek.

Medical History and Status:  Sinusitis every winter, concussion in childhood, right knee inspection biopsy in childhood, dizziness, and malformation of the right kidney.

CT Scan:  Deviation of the nasal septum to the right, large left concha.

Evaluation:

Observation:  

  Flattening of the right side of the face

  Slight deviation of the mandible to the left, while opening the mouth

  Elevated shoulders, thoracic kyphosis

Transverse on the body, mapping was positive in these areas:

  T7-8-9, central and paravertebral

  Central L3

  L5-S1

  C6 central and paravertebral

  Left occiput and lambdoidal suture

  Bilateral frontals

  Right parietal, temporal, zygoma and maxilla

  Right quadriceps muscle

No complaints about other areas or dysfunction

Treatment:  Altogether the patient received 9 hours of treatment, 6 of them on a weekly basis, one on week 12, one on week 16, and the last one on week 18.  In the beginning, the patient was asked to perform 1 hour of Neuro-Fascial Processing from each one of the following areas, with the ureters:  right and left frontal, left and right occiput, right parietal, temporal, zygoma, and maxilla.  She could not perform the NFP from the occiput, due to the appearance of dizziness immediately when touching the occiput.  The first treatment began with Muscle Therapy Technique for the right quadriceps muscle.  That was enough to make the transverse mapping over the muscle negative.  Then I proceeded with treating the sacrum, which was found to be descended.  During the following sessions, the patient was treated with techniques from the first 2 Cranial Therapy courses (CTS1, CTS2), by Sharon Weiselfish-Giammatteo:

  Osseous Release #3

  Dural Release

  Foramen Release # 3, 9, 11

  Gear Complex Assessment and Treatment

The patient was treated with Myofascial Techniques for the right zygomaticomaxillary, squamosal, sphenosquamosal, and lambdoidal sutures (lamillas).  Bone bruise technique was utilized wherever it was necessary.  Immune deficiency motility was treated as necessary.  The patient was checked and treated according to Muscle Energy guidelines.  Still spaces over T4 right maxilla and right zygoma were opened with the heart.

Results:  Gradual improvement was reported during the treatment period.  The medications were more effective for the patient.  Afterwards there were more pain free days and she could cope with the headaches with no need to use medication.  The patient was less severe, less radiating, and more focused on a little area in the right parietal bone.  After 8 treatments, the patient counted only 4 days of having headaches during a months time and days 12-15 of her cycle.  A few months after the last treatment, the patient reported further improvements and a decrease in frequency and intensity of her headaches.  Although the treatment was not completed, there still remained a difficulty in releasing the foramen magnum and the left tentorium had adhesions in the area of attachment of the left temporal bone.  Several bone bruises were still noted and the squamosal and sphenosquamosal sutures were not mobile in all directions.  The patient was satisfied with the results.

Discussion:  Headaches of about 30 years, which did not respond to any sort of medication, were improved over a short period of treatment, using very basic techniques of Integrative Manual Therapy.  One may assume that by utilizing advanced knowledge in this treatment approach, better results could be achieved.  This case study demonstrates the efficiency of this treatment method, in improving her quality of life, despite suffering for several years.