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Automated Slow Movement Mobilizations

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a Case history;

Jeanet signed up for treatment at Nekz 2 months ago.

Recently (4 weeks before) she had a car accident and has had neck and headache complaints since that time. These complaints are different from her "Migraine" that she experienced since early childhood.

History

1.5 months ago, her car was hit from behind with low impact at the traffic light. First and second day she experienced some muscle pain in the ventral side of the neck. After that she developed some problems with looking up and with full rotation to the right side. During daytime only few complaints but at night she had more problems finding a correct sleeping position. Furthermore, no forgetfulness and concentration problems. It's been constant for the past few weeks.

Jeanet is known to have migraines (not increasing), on the right side of her head. Medication does help but often she spits it out and she lies flat for 2 days. Occurrence is very variable in number, this year very regularly every 3 weeks (even before accident).

As a child she never had headaches. She remembers she ever had a mild concussion but not clear if the “Migraines” start after this event. There are no auras or other symptoms which direct to the diagnosis being Migraine. Her headaches normally show up in the morning.

Jeanet has no shoulder and/or arm complaints.

Last months every 3 to 4 weeks 2 days flat due to "Migraine".

When asked about her "Migraine" complaints, there are a few factors that make me doubt the diagnosis of "Migraine".

Her complaints are mainly localized in the Occipital region and spread forward. It may just as well be of a cervicogenic origin (i.e., headache caused by neck problems).

Physical examination: (abbreviated view)

Jeanet positions her head forward (antero-position), she has multiple positive pressure points in the upper neck area and there is a sharp pain spot at the right C1/2 joint. Testing for mobility in the upper neck shows limitation at the C1/2 complex towards the right side (CFRT right 17/45 degrees).

Therapy:

Starts with mobilizing the upper neck region (between C1 and C2 in three-dimensional direction on the Occifex). If this mobilization will succeed, then rotation to the right will provoke less load on the level where the neck pain is caused by the collision, and it will be beneficial for the upper neck-joints.

Result:

After the first treatment, the rotation in the upper cervical has already greatly improved (CFRT right 31/45 degrees).

The complaints caused by the accident were gone in two sessions. The so called “Migraine” was most surely a cervicogenic headache and didn’t occur after the fifth treatment.

She changed some of her sleeping habits and continues with her exercises.

Jeanet, now in her fifties has had a long history of disabling headaches. With a proper diagnosis and a straightforward treatment on the Occiflex (no riskfull high velocity thrust manipulation) she was cured in a few visits.

Jeanet: “For me the accident turned out to be a blessing in disguise”.

In fact, the minor accident with her car made her to get rid of her disabling “Migraine”.

André Wapenaar,

Nekz (Netherlands)