Role of Manual Physical Therapy and Specific Exercise Intervention in the Treatment of a Patient with Cervicogenic Headaches: A Case Report

Headaches are a common complaint among patients seeking medical care. This case report highlights the role of physical therapy (PT) management including manual therapy and specific exercise interventions in the care of a patient with cervicogenic headaches. The patient was an 18-year-old female college student with a medical diagnosis of migraine headaches. Her history included three previous motor vehicle accidents. Treatment from her primary care physician and optometrist had had no effect on her headache intensity and frequency. Findings on the PT examination included upper cervical segmental restrictions and neuromuscular imbalances. The primary treatment strategy for this patient included cervical manipulation, neuromuscular retraining of deep neck flexors, and soft tissue manipulation. The patient demonstrated improvement with a total of seven treatment sessions over a five-week period. Neck Pain Disability Index score improved from a score of 38% perceived disability at initial examination to a score of 10% upon discharge. Headache frequency and intensity significantly improved as upper cervical segmental mobility and deep cervical flexor function improved to within normal limits. This case report demonstrates the potential role of manual physical therapy and specific exercise intervention in quickly improving function and impairments in a patient with cervicogenic headaches.