Author: Richard H. Adler

One area of controversy within the insurance and medical communities is the role of the cervical spine in the causation of headaches. How can an injury to the cervical spine cause headaches? Is there a role for spinal manipulation in the management of headaches?

A recent study published in the Journal of Manual Medicine entitled, "Spinal Manipulation and Headaches of Cervical Origin," Spring 1991, volume 6, pgs. 73-79, provides an excellent literature review of the reported clinical studies in which spinal manipulation was applied as the primary therapeutic agent. This study can be used by a treating doctor to justify the reasonableness and necessity of chiropractic care for the treatment of headaches stemming from a cervical acceleration/deceleration type injury.

This study also summarizes other research articles and concludes that manipulation has an eighty to ninety percent overall success rate in resolving muscle contraction headaches. In addition, the study reports noticeably good results in the treatment of migraine headaches through the use of spinal manipulation.

I am enclosing a copy of this recently published article. It may be used to educate patients and staff, as well as to assist you when writing reports to insurance companies and defending your opinions at the time of deposition or trial.

Very truly yours,
ADLER GIERSCH, P.S.

Richard H. Adler
Attorney at Law

¹ Remember, however, that if the patient's headaches persist and are accompanied by other symptoms such as dizziness, fatigue, ringing in the ears, concentration problems, sleeping difficulties, and/or visual dysfunction, then the headaches may not be muscle contraction type headaches or migraine headaches. The source of the headaches may be from a closed-head injury. In this instance, a referral to a neurologist specializing in head injuries would be most appropriate.