Date of Award

2022

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

Romanick, Mark

Abstract

Background and Purpose. Headaches are one of the most common disorders globally, with a potential for major disability. According to the World Health Organization (WHO) roughly 50% of the population globally are affected by headaches. The WHO states that 50-75% of adults within the last year report neck pain associated with headaches, while 30 % of these individuals reported they were experiencing migraines. The main types of headaches include tension, cluster, migraine and cervicogenic. The purpose of this case report is to see if my patient experienced a positive outcome while in my care with the use of manual therapy interventions, while specifically utilizing Mulligan and McKenzie techniques, along with dry needling, and modalities such as superficial heat for treatment.

Case Description. The patient I worked with is a 23 year old Caucasian male suffering from chronic headaches associated with hearing and visual loss. He is working full time inventorying cargo and the headaches cause severe pain causing him to call off work. Intervention. Primary intervention focused of manual therapies. Intervention such as McKenzie and Mulligan techniques were used, dry needling, and modalities such as superficial heat.

Outcomes. My patient decreased the Neck Disability Index impairment level from 40% to 26 % to 0% impairment thus meeting one of his long term goals. He demonstrated an increased range of motion in all planes of the cervical spine. He increased cervical flexion by 40 degrees, DocuSign Envelope ID: 5D4C2FF6-C0BB-4F4E-B502-DE07614DE513 ix gaining 20 degrees of cervical extension, and increasing cervical rotation by 30 degrees in each direction. He also demonstrated an increase in strength of the rhomboids and middle trapezius improving from a fair 3/5 manual muscle test to 5/5 by discharge.

Discussion. The individual increased cervical range of motion in all directions, decreased pain, and decreased headache symptoms. My patient increased cervical flexion, extension, and cervical rotation. We also noted positive effects of dry needling, which loosened structures in the neck and allowed the patient to improve range of motion. This case study showed significant outcomes for dry needling, mobilization of the cervical spine, and superficial heat.

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