Recent evidence suggests a substantial role for chiropractic and exercise in treating headache. The majority of chronic neck pain patients post-whiplash injury have significant pain originating from their cervical facet joints. Chronic headache patients exhibit deep neck flexor weakness. Postconcussion headache sufferers also have a weakness of their deep neck flexors, forward head posture and tightening of the suboccipital muscles.
Chiropractic manipulation and exercise are indicated as the treatments of choice based on this research.
Whiplash Injury with Headache Treatment Protocol:
- Postural correction (lumbar support during sitting)
- Adjustments (C0-C1, lower cervical, and cervicothoracic)
- Muscle relaxation (SCM, upper trapezius, levator scapulae)
- Stretching (suboccipital, pectorals, hamstrings, erector spinae)
- Strengthening (deep neck flexors, abdominals, gluteals, erector spinae)
- Propriosensory retraining
- Barnsely L, Lord SM, Wallis BJ, Bogduk. The prevalence of chronic cervical zygapophyseal joint pain after whiplash. Spine 1995;20:20-26.
- Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalgia 1993:13;272-284.
- Treleaven J, Jull G, Atkinson L. Cervical musculoskeletal dysfunction in postconcussional headache. Cephalgia 1994;14:273-279.
- Janda V. Evaluation of muscular imbalance. In Rehabilitation of the Spine: A Practitioner's Manual, Liebenson C (ed). Williams and Wilkins, Baltimore, 1995.