Therapy may relieve often misdiagnosed headache
As Printed in The Herald News Wednesday, November 5, 2008
Dannielle Peterson, of Channahon, began suffering headaches that continuously got worse over a period of a couple of months. Before she could find relief, she was seen by many doctors, underwent test after test after test, was taking several medications and endured months of unrelenting pain.
There are 150 types of headaches recognized by the International Headache Society. Many are treated with medications, changes in diet or changes in stress levels. Only one has been scientifically shown to respond to treatment of specialized physical therapy – the cervicogenic headache.
Dannielle was finally diagnosed properly with a cervicogenic type of headache, but her experience is not uncommon. While this type of headache can be treated successfully, it is often misdiagnosed because the symptoms can mimic other kinds.
Headache’s origin
A cervicogenic headache arises when the structures in the first three bones of the neck, including the muscles, disc, nerves and joints, become irritated. The nerve endings send pain messages to the central area of the brain. Because that part of the brain receives messages from several areas, it becomes difficult to determine exactly where the pain originates.
That’s what makes diagnosis so difficult, said Jayne Sutcliffe, physical therapist and co-owner of Pro-Motion Physical Therapy in Minooka.
Dannielle’s internist, Dr. Lynn Drab of Channahon, had recently heard a presentation by Sutcliffe and her partner Paul Humprhries on treatment options for cervicogenic headaches. Sutcliffe and Humphries are the only physical therapists in the Chicagoland area with the specialized training needed to treat these headaches.
Dannielle’s headache affected her head, sinuses, neck and jaw on one side. At first she thought she had allergies and tried to tough it out. But over a two month period, it gradually became worse.
“For two to three months it was restless sleeping for her,” said husband Aaron Peterson. “She’d cry herself to sleep every night.”
Danielle was taking ibuprofen like candy, she said. Eventually she couldn’t hold down much food and vomited so much she was spitting up blood.
Similar symptoms
Her headaches were being treated as migraines because of the similar symptoms, said Dannielle. After one bad episode she was taken to a local hospital by ambulance. After a five day stay, she was transferred to the University of Chicago Hospital.
Many physicians examined Dannielle in Chicago. She was given shots in her neck to numb the pain and when they hit the spot with the most intense pain, they finally knew what they were dealing with. “That’s when they really knew what it was,” she said.
Although she doesn’t blame anyone for misdiagnosing her, Dannielle is frustrated over the amount of time she was in pain and the money it cost to get a correct diagnosis.
With the proper diagnosis to go by, Drab sent Dannielle to Pro-Motion Physical Therapy.
Sutcliffe treated Dannielle with a technique called joint mobilization and a low-load specific exercise program. Dannielle began to experience relief. She met with Sutcliffe twice a week for about six weeks and now she is pain free.
“(At first) I was scared to have Jayne touch me, but she took it gentle,” said Dannielle. “Her hands knew (where to work). She’s trained in how to figure out what spot it is. By the third visit, I was seeing a difference.”
Specific treatment
Not all headaches respond to physical therapy, but a cervicogenic is one type that Sutcliffe knows she can treat, she said. “It’s a very specific treatment. It’s going to help if there is a mechanical source to the headache.”
Not many people, or even physicians, are aware of cervicogenic headaches, Sutcliffe said. Patients can watch for specific symptoms, including pain on one side starting in the upper neck and can be felt in the back, side and front of the head. Shoulder and arm pain can be present. Headaches increase with neck movement or awkward positions, neck movement is restricted, there’s pain to the touch in the upper neck and medications have little or no affect.
Sometimes a cervicogenic headache can be present with other types, such as a migraine, Sutcliffe said. But Pro-Motion can treat the cervicogenic and medication would still be used for the migraine.
“The thing we get excited about,” said Humphries, “is when people come in and (others) couldn’t do anything with them, and we can get results.”
Dannielle has been pain free now for six months and she owes it all to Sutcliffe. “I didn’t want to be on all that medication. It was such a relief to rely on someone’s hands and their training,” Dannielle said. “I don’t wish that pain upon anybody and I hope no one else has to go through that.”
