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Improvement in Radiographic Measurements, Posture, Pain & Quality of Life in Non-migraine Headache Patients Undergoing Upper Cervical Chiropractic Care: A Retrospective Practice Based Study

James Palmer Ph.D, Marshall Dickholtz DC

Journal of Vertebral Subluxation Research ~ June 4, 2009 ~ Pages 1-11




Background: There is research supporting nociceptive structures in the cervical spine as a common origin for symptoms meeting International Headache Society diagnostic criteria for tension-type headache and cervicogenic headache. The potential to screen non-migraine headache subjects for referral based on posture, and to have that referral meet with a high level of success, is important to health care and to headache research.


Objective: To determine if signs of postural imbalance and X-rays provide measurable indicators of cervical disarrangement related to non-migraine headaches and to determine the effectiveness in everyday practice of manual vectored adjustment of the atlas for attenuation of non-migraine headache pain intensity.


Methods: Progression of patients with non-migraine headache following manual, vectored-adjustment of the atlas was assessed by and correlated with pre- to post- adjustment changes in measurements from cervical radiographs, wellness and pain scale instruments, and load and non-load bearing modes of posture. Time-series analysis of VAS scores on patients who were adjusted once is fit to an exponential decay curve.


Results: There was statistically significant improvement in postural measurement, X-ray measurements, and in all wellness categories from pre-treatment to post-treatment. Time series analysis of the visual analog pain scale assessments showed a significant reduction in pain intensity within two weeks of treatment for those who received only a single treatment and that the pain intensity for the single-treatment group decreased by approximately 75 percent over the study period.


Conclusion: Correction of the atlas subluxation complex using National Upper Cervical Chiropractic Association (NUCCA) protocol may be a possible analgesic for non-migraine- especially cervicogenic- headache.


Key Words: Non-migraine headache, cervicogenic headache, tension headache, SF-36 questionnaire, VAS pain assessment, supine leg length alignment asymmetry, contractured leg, atlas laterality, atlas, C-1, vectored manipulation, subluxation, adjustment, NUCCA Technique, practice based research



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