Resolution of Chronic Migraine Headaches and Improvement in Cervical Spine Kyphosis Following Chiropractic BioPhysics® (CBP®) Treatment: A Case Report With a Seven-Month Follow-Up

Abstract

We present a chronic migraine (CM) patient demonstrating significant improvement in subjective and objective reported outcome measures with deeper cervical lordosis parameters and reduced forward head posture on radiographs. A 29-year-old male suffered from CM reporting significant pain and disability with aural, sensory, and motor disturbances during the migraine headaches. Aura with visual disturbances, abnormal facial and extremity sensation, sporadic motor weakness, and other signs of CM were found in the patient's history since age 10. The patient reported previous physical therapy, manual chiropractic, and over-the-counter medications. Migraine-specific prescriptions without long-term reduction in pain and disability were reported. The pain and suffering had been reported to be worsening, and he sought Chiropractic BioPhysics^® (CBP^®) spine and postural rehabilitation protocols. These protocols were used to increase cervical lordosis, reduce coronal imbalances, increase mobility, and create better posture. These protocols include specific prescriptions based on radiography for postural exercises, postural mirror image^® (MI^®)traction, and specific spinal manipulative therapy (SMT) focused on posture. All outcome measures improved with the resolution of all initial symptoms of CM. There was a 16° improvement in cervical lordosis, a 30% decrease in headache disability, and additional improvements. These improvements were maintained at a seven-month follow-up during which the patient received infrequent maintenance treatments. This successful treatment of a patient with CM with long-term follow-up adds to evidence that CBP^® spinal structural rehabilitation may prove effective and serve as a possible tool for clinicians, physicians, and therapists to treat CM.

Keywords: cervical lateral radiograph; cervical lordosis; chiropractic biophysics; headache; migraine; sagittal balance; spine alignment.

Figure 1. Upright lateral cervical radiograph at the initial examination. The red lines outline the posterior vertebral body margins. The measurements above show the absolute rotation angle (ARA) of -1.3° where a more ideal lordosis would approximate -42° from C2 to C7 (green line). The measurements on the left demonstrate the individual relative rotation of each pair of vertebrae; the patient’s values are listed outside the brackets, and the ideal values are listed inside the brackets.

Figure 2. A standing exercise involving cervical extension and head posterior translation with the ProLordotic® resistance trainer under the influence of whole-body vibration with the Power Plate® designed to strengthen the cervical muscular in the mirror image (MI®) of the patient’s initial cervical hypolordosis.

Figure 3. Mirror image® cervical extension traction. The patient is seated, and the torso is restrained with a Velcro strap. Two forces are applied to the cervical spine with the patient’s neck in extension. The posterior pull prevents the patient’s head from being pulled forward, and the anterior pull is applied through the kyphotic deformity.

Figure 4. Post-treatment re-examination lateral cervical radiograph following 24 in-office treatments using CBP® protocol. The cervical lordosis improved to -17.3° (vs. -1.3° initially), the atlas plane line improved to -24.2° (vs. -10.9° initially), and the anterior head translation reduced to 22.3 mm (vs. 35 mm initially). The kyphotic C2-C3 segment improved to +2.7° (vs. +9.7° initially).

CBP®: Chiropractic BioPhysics®.

Figure 5. Follow-up re-examination lateral cervical radiograph after seven months of maintenance treatments. The cervical lordosis lost some of the initial correction and was -11.7° (vs. -1.3° initially), the atlas plane line was maintained at -21.1° (vs. -10.9° initially), and the anterior head translation maintained at 24.1 mm (vs. 35 mm initially). The kyphotic C2-C3 segment measured +4.6° (vs. +9.7° initially).