Pain Arising in the Posterior Arch of the Atlas

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Abstract
Headache of cervical origin is by no means an adequate diagnosis. The exact mechanism has to be established for the case in question. A type of cervical headache which arises from the posterior arch of the atlas is described. The basic finding is tenderness of this structure on palpation; the technique of palpation is described. In a majority of cases movement restriction (blockage) between the occiput and the atlas is found. The headache as described by the patient is not characteristic, migrainous attacks being present in about one-third of the cases. A frequent feature is pain on retroflexion of the head. Treatment consists of manipulation of the blockage, and infiltration or needling of the posterior arch of the atlas if there is no blockage or if pain continues after the restoration of mobility. In the more complicated cases remedial exercise is indicated. Experience with 64 cases is described.

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