title: A holistic approach to severe headache symptoms in a patient unresponsive to regional manual therapy.
abstract: OBJECTIVE
  To discuss the case of a patient suffering from severe headache complaints who was previously unresponsive to regional cervical spine care.
  
  
  METHODS
  A prodrome was described. In addition to headache itself, associated symptoms included light sensitivity, blurred vision and nausea. A visit to a hospital emergency room was often necessary to reduce pain intensity.
  
  
  RESULTS
  Manual chiropractic spinal adjustment were performed as the only treatment intervention. After a course of treatment, the patient reported no visits to the emergency room, even after a 1-yr follow-up, and the average visual analogue pain scores decreased.
  
  
  CONCLUSIONS
  This patient seemed to respond favorably to conservative care that included regions of spine not traditionally associated with headache pain. This suggests that some individuals may require a more comprehensive evaluation if regional care fails to promote a positive response within a few weeks. Controlled, randomized trials will assist in comparing effectiveness of various treatment interventions.
authors.affiliation: Wolfe-Harris Center for Clinical Studies, Northwestern College of Chiropractic, Bloomington, Minnesota 55431, USA.
authors.forename: D E
authors.initials: DE
authors.lastname: Stude
authors.forename: J J
authors.initials: JJ
authors.lastname: Sweere
mesh_terms: D000328:Adult; D002684:Chiropractic / Q000379:methods*; D005260:Female; D006261:Headache / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D010147:Pain Measurement; D011859:Radiography; D013131:Spine / Q000000981:diagnostic imaging