Background: Headaches in children are common and their care presents a challenge to both allopathic and non-allopathic physicians. A majority of children who experience recurrent headaches have migraines. Prevalence estimates indicate that up to 10.6% of children ages 5 to 15 years and 28% of adolescents between the ages of 15 and 19 years experience migraine headaches 1 2 Their recurrence have an impact on a child’s life in a number of ways, including school absences and reduction in performance, decreased home and family interactions, and decreased socialization with peers. A study by Hershey et. al. 3 using the Pediatric Migraine Disability Assessment - a questionnaire that assesses a child’s disability in school, home, and play activities, found in a study population of school-aged children and adolescents of having a moderate to severe disability. Considering that a common medical approach to this condition is the use pharmacologic methods and that off-label drug prescribing is a common phenomenon in the management of children 4, the concern of parents regarding the adverse reactions to these pharmacological interventions as well as the need for safer alternatives contributes to the growing popularity of pediatric chiropractic. To contribute to the body of knowledge on the alternative approaches to the care of this type of pediatric population, we present the successful chiropractic care of a patient with chronic migraine headaches.
Clinical Features: The pediatric patient was brought in by his mother for chiropractic evaluation and care for chronic headaches with an onset since age 7 years. The headaches are described as “throbbing” with a frequency of at least one severe headache every 7 weeks and 2-3 less severe headaches every month. Previous and unsuccessful care consisted of over-the-counter medication in the way of Motrin and Ecotrin. Chiropractic examination revealed subluxation findings at the C1, C2, and T4 vertebral levels as well as at the sacrum.
Intervention and Outcome: The patient was cared for with adjustments to sites of vertebral subluxations. Within a period of one month consisting of 5 patient visits, the patient did not experience any headache. Long term follow-up at 13 months revealed the patient experiencing only a couple of “mild” headaches during this time. At 19 months follow-up, the patient did not experience any headaches the previous six months.
Conclusion: This case report provides supporting evidence on the effectiveness of chiropractic care in children with headaches.
- Abu-Arefeh I, Russell G. Prevalence of headache and migraine in schoolchildren. BMJ. 1994; 309:765–769.
- Split W, Neuman W. Epidemiology of migraine among students from randomly selected secondary schools in Lodz. Headache. 1999; 39: 494–501.
- Hershey AD, Powers SW, Vockell AL, LeCates S, Kabbouche MA, Maynard MK. PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology. 2001;57:2034–2039.
- Cuzzolin L, Zaccaron A, Fanos V. Unlicensed and off-label uses of drugs in paediatrics: a review of the literature. Fundam Clin Pharmacol. 2003;17:125-31
Joel Alcantara, D.C. 1 and Kyle J. Pankonin, D.C. 2
- Research Director, International Chiropractic Pediatric Association, Media, Pa and Private Practice of Chiropractic, San Jose, CA and Milpitas, CA
- Private Practice of Chiropractic, Lamberton, MN
Presented at ACC-RAC Conference in Las Vegas, NV March 17-20, 2005.