Resolution of Refractory Headache Symptoms Following Cervical Spinal Manipulation and Electrical Dry Needling in an Adolescent Female: A Case Report.

Cervicogenic headache (CGH) in adolescents is poorly understood. The overlap in signs and symptoms between CGH, tension-type headaches and migraine headaches complicate the differential diagnosis. Furthermore, poor outcomes for CGH with conventional pharmacology is not uncommon. Adolescents presenting with cephalgia should be screened appropriately for cervical etiology. Evidence supports the use of upper cervical spinal manipulation and dry needling for the treatment of CGH in the adult population. However, there is a lack of evidence supporting the diagnosis and treatment of CGH in adolescents. This case report describes the clinical diagnosis and successful management of a 16-year-old female with chronic, frequent episodic CGH that was refractory to polypharmacy. The patient was able to stop taking all medication for her headaches and reported resolution of pain and disability, following 4-weeks of upper-cervical spine thrust manipulation and electrical dry needling.