Remission of Dowager’s hump by manipulative correction of spinal alignment: a case report

Abstract

Dowager’s hump is described as excessive kyphotic curvature in the thoracic spine with a Cobb angle of more than 40 degrees. This case report presents a 61 years old female office clerk who experienced headaches and neck pain for 3 years that extended into her right shoulder and upper chest. She consulted her primary care physician two months before seeing the chiropractor when the neck pain worsened. A diagnosis of cervicalgia related to osteoarthritis was made based on cervical and thoracic X-ray findings. The patient received non-steroid anti-inflammatory drugs (celecoxib and etoricoxib) and stretching exercises at home. At the onset of chiropractic care, radiographs showed loss of cervical lordosis, narrowing at the C4-5, C5-C6, and C6-7 intervertebral disc space with marginal osteophytes. Based on these findings, a working diagnosis of cervicogenic headache was established. After treatment for 9 months, the patient showed improvement in symptoms and function from cervical curve radiographic change and dextro-convexity of the thoracic spine. Avoiding forward head flexion and maintaining correct posture in daily activities will be key mechanisms to prevent the reoccurrence of Dowager’s hump. The improvement of symptoms following chiropractic therapy has been shown to correlate with radiographic markers of spinal realignment.

Integrative Physiotherapy Management of Cervical Radiculopathy and Concurrent Tarlov Cysts

“…The absence of a positive cervical distraction test led to the exclusion of mechanical traction from the treatment regimen. Past and current studies also highlighted the effectiveness of thoracic thrust manipulation in enhancing cervical active range of motion and mitigating neck pain [ 20 , 21 ]. Neural mobilization techniques and soft tissue mobilization have gained prominence as integral treatments for cervical radiculopathy [ 22 ].…”

Effectiveness of Nonpharmacological Measures on Improving Headache Score, Strength, Pain, and Quality of Life in Cervicogenic Headaches: A Systematic Review

“…Despite being recognized for over three decades, CGH remains a treatment challenge. Fortunately, a multimodal approach combining medication and nonpharmacological therapies, like exercise, spinal manipulation, and soft tissue therapy, has proven effective [4][5][6]. Treatment options can also include minimally invasive percutaneous techniques for targeted pain relief, with surgery reserved for severe cases [7].…”