The Use of Dry Needling in Combination With Manual Therapy Techniques for a Patient with Cervicogenic Headache: A Case Report

The purpose of this case report was to describe the use of suboccipital and paravertebral dry needling in combination with manual therapy for a patient with chronic cervicogenic headaches. A 24-year-old female, with a 12 year history of cervicogenic headaches, received a combination of joint mobilization and manipulation, myofascial techniques to normalize muscle tone and muscle length, strengthening exercises, posture correction, and dry needling techniques to the sub-occipital and paravertebral C4-T1 region for a total of nine visits over a 5 week time span. Following the first three treatments improvement in motion was present; however, no change in headaches was reported. After the inclusion of suboccipital and C4-T1 paravertebral dry needling to the treatment program, the VAS and NDI scores showed significant subjective improvement. The patient reported a significant reduction in headaches and was headache free at treatment nine. This case study suggests that improvement in cervical motion alone does not necessarily result in reduction of cervicogenic headaches. The use of dry needling appeared to have been beneficial to reduce muscle tone. Dry needling may prove to be a beneficial treatment modality for physical therapists when treating patients with cervicogenic headaches.