History
The patient was referred to me for very specific Physiotherapy by her Dentist. She had an 11-year history of chronic daily headaches which had become more severe and more constant since November 2014. She described her headaches as constantly present and experienced them as being on her forehead and behind both eyes with an intensity ranging from 4-6/10. Other symptoms reported include tenderness in the area in front of her ears and under her jaw, left sided ear ringing and a sensation of ‘brain fog’. She also experienced stiffness and discomfort at the back of her head and neck. The patient suffers anxiety, clenches her teeth during the day and night and had been told by her dentist that she has a tooth grinding habit. The patient has tried many approaches for her headaches and related symptoms which have included medication and diet elimination approaches. She has also tried a different Physiotherapy approach but none addressing her jaw specifically.
Examination
The patient had poor posture with stiffness and tenderness in all associated jaw and neck structures which reproduced aspects of her headache and other symptoms. Her postural habits, jaw clenching and grinding were other contributing factors to her issues
Response to very specific Physiotherapy Treatment
The patient has responded extremely well to physiotherapy treatment which has focused on improving mechanics at both the neck and jaw and educating her about correct work and sleeping postures. She reported a marked reduction in the intensity (1-2/10) and frequency of her headaches (now only very occasional) which are shorter in duration when they do occur. The patient has also reduced her medication. She is followed up roughly every 2 months currently and is almost headache free at the time of writing this case study.