A 54-year-old female presented with classic migraines. Migraines began when she was 10-years-old. She was having an average of 8-9 migraines per month. Migraine pain was located in her left shoulder and would radiate up to her left temple and left eye. She has been relying on migraine abortive medications, monthly injections and has exhausted all conservative care options such as chiropractic, physical therapy, massage therapy and acupuncture. Migraines had been unresponsive to these therapies. Abortive medications would help to rid the migraine once it has begun. The patient reported using up to 8 or 9 migraine abortives per month.
Neurological examination revealed left sided midbrain dysfunction. Physical examination revealed a left shoulder stability motor control dysfunction in external and internal rotation. Patient’s posture demonstrated an anterior head carriage. Palpatory findings revealed hypertonic upper trapezius muscle, pectoralis major and sub occipital muscles on the left side and weakness in the lower trapezius muscle and thoracic paraspinal musculature.
Recommended treatment for this patient was neurological rehabilitation twice a week for 5 weeks followed by a re-evaluation. Treatment involved oculomotor exercises, cortical exercises, corrective exercises to the patient’s left shoulder, chiropractic manipulative therapy to the thoracic and cervical spine, electrical muscle stimulation, and red light therapy. During treatment, the patient was put on a food elimination regimen in which they eliminated gluten, dairy, caffeine, and alcohol from their diet for six weeks.
At the first re-examination, the patient reported that she had not had to take an abortive medication in two months, and she had not had a severe migraine since the beginning of treatment. She reported that her shoulder and back are no longer sore and she is sleeping better.
After the initial re-examination, the patient was given a home neurological and biomechanical exercise regimen. From then, the patient came into the office to receive chiropractic manipulative therapy every 3-4 weeks.
Currently, the patient has reported that she has not suffered any migraines for 3-4 months. Incorporation of gluten, dairy, caffeine and alcohol have been made into her diet successfully. Patient still receives chiropractic manipulative therapy every 4-6 weeks.
Functional neurological care and chiropractic manipulative therapy have been shown to be effective in the treatment of classic migraines. Every patient requires an individualized approach and targeted treatment to achieve optimal results.