The Benefits of Integrative Manual Therapy on Neck Pain and Headaches
Author: Terri L. Koziell, PT
Abstract: This case study will show that a patient presenting with subjective complaints of cervical pain and headache symptoms responded positively to Integrative Manual Therapy to decrease her overall subjective symptoms and eliminate a suspect meningioma as seen on MRI studies.
Key Words: Headache, Neck Pain, Fusion, MVA, Whiplash
The patient was a 53-year-old, female, who was diagnosed with cervical and head pain. Past medical history was significant for right frozen shoulder in 1995 and congenital fusion at C-5. Traumatic history was significant for motor vehicle accident in 1990 with severe whiplash and head injury resulting in some short-term expressive aphasia. Physician referred patient for therapy as per patient request, ordered MRI studies, and made further referral to a neurosurgeon.
Upon evaluation, patient presented with subjective complaints of posterior spine pain radiating to the occipital area and further up to the top of the head. She complained of constant pressure at the occipital region.
Treatments & Outcomes
Treatment: The patient was treated using the Integrative Manual Therapy (1) approach. Session one of treatment involved balancing the pelvis and lumbo-sacral region using Muscle Energy and ‘Beyond’ Techniques.
Outcome: An MRI of the head was done subsequent to the first session of treatment. The report indicated that "There is a subtle finding of a crescentic extra-axial region of soft tissue signal intensity which is at the parieto-occipital junction at the level of the splenium of the corpus callosum and this measures approximately 4-5 mm in thickness and may reflect a small meningioma" (1).
Sessions Two & Three:
2nd Treatment: Session two of treatment consisted of using Advanced Strain and Counterstrain techniques for all cervical and cranial vasculature.
3rd Treatment: Session three of treatment consisted of using the Compression Syndromes for the foramen magnum, jugular foramen, and mastoid foramen. Both Disruptions of Membrane and Bone Bruises were assessed and treated for the occipital, mastoid, and parietal region.
2nd and 3rd Session Outcome: The follow-up MRI study with Gadolinium was done subsequent to the third session of treatment. The report indicated, "There is no evidence of pathologic intra nor extra-axial contrast enhancement. The brain maintains normal overall morphology and signal" (3). It should be noted that the same physician read both MRI studies.
Treatment continued with various techniques from the Cranial Therapy Series during the next three treatment sessions.
By the completion of the seventh session, the patient reported that 75% of her symptoms were completely alleviated. She also reported a significant decrease of pressure in her head and overall increase in her range of motion. She also indicated that she had improvements in reaching activities, which previously elicited pain in her neck and right shoulder since 1995.
In conclusion, I believe this study demonstrates the positive effects of using the Integrative Manual Therapy approach for treatment.
1. Integrative Manual Therapyã is an approach of evaluation, diagnostics and treatment, which has been developed, by Sharon Weiselfish-Giammatteo, Ph.D., P.T. and Thomas Giammatteo, D.C., P.T.
2. MRI study dated 1/26/00 from Northeastern MRI Imaging Center; 2601 Stafford Ave., Scranton, PA.
3. MRI study dated 1/27/00 from Northeastern MRI Imaging Center; 2601 Stafford
Ave., Scranton, PA.