Moore Michele K
J Manipulative Physiol Ther. 2004 Jul-Aug;27(6):414-20. doi: 10.1016/j.jmpt.2004.05.007.
To discuss the management of upper crossed syndrome and cervicogenic headache with chiropractic care, myofascial release, and exercise.
A 56-year-old male writer had been having constant 1-sided headaches radiating into the right eye twice weekly for the past 5 years. Tenderness to palpation was elicited from the occiput to T4 bilaterally. Trigger points were palpated in the pectoralis major, levator scapulae, upper trapezius, and supraspinatus muscles bilaterally. Range of motion in the cervical region was decreased in all ranges and was painful. Visual examination demonstrated severe forward translation of the head, rounded shoulders, and right cervical translation.
The patient was adjusted using high-velocity, short-lever arm manipulation procedures (diversified technique) and was given interferential myofascial release and cryotherapy 3 times weekly for 2 weeks. He progressed to stretching and isometric exercise, McKenzie retraction exercises, and physioball for proprioception, among other therapies. The patient's initial headache lasted 4 days. He had a second headache for 1.5 days during his exercise training. During the next 7 months while returning to the clinic twice monthly for an elective chiropractic maintenance program, his headaches did not recur. He also had improvement on radiograph.
The principles of upper crossed syndrome and the use of exercise, chiropractic care, and myofascial release in the treatment of cervicogenic headache are discussed. A review of the literature indicates that analyzing muscle imbalance as well as vertebral subluxation may increase the effectiveness of chiropractic treatment for cervicogenic headache.
探讨运用整脊疗法、肌筋膜放松和运动来管理上交叉综合征和颈源性头痛。
一名56岁的男性作家，在过去5年中每周有两次持续的单侧头痛，并向右眼放射。双侧从枕骨到T4触诊有压痛。双侧胸大肌、肩胛提肌、上斜方肌和冈上肌可触及触发点。颈椎各方向活动度均减小且疼痛。视诊显示头部严重前倾、圆肩和右侧颈椎移位。
采用高速短杠杆臂手法操作程序（多样技术）对患者进行整脊调整，并每周进行3次干扰性肌筋膜放松和冷冻疗法，持续2周。他逐渐开始进行拉伸和等长运动、麦肯齐后缩运动以及使用健身球进行本体感觉训练等其他治疗。患者最初的头痛持续了4天。在运动训练期间，他又出现了一次持续1.5天的头痛。在接下来的7个月里，他每月回诊所两次接受选择性整脊维护治疗，期间头痛未再复发。他的X光片也有改善。
讨论了上交叉综合征的原理以及运动、整脊疗法和肌筋膜放松在治疗颈源性头痛中的应用。文献综述表明，分析肌肉失衡以及椎体半脱位可能会提高整脊疗法治疗颈源性头痛的效果。
