Neck pain with headaches

Hi,

I'm currently treating a patient and would welcome some ideas and advice. The details are as follows:

H/o 6mnth neck pain of sudden onset following trauma (a child 'swung' on neck). The pain is sharp with bilateral distribution and immediate spasm on all movements. A dull ache persists in L + R traps. Pins and needles are intermittent but frequent headaches occur at C2/3. The Sx worsen upon waking.

The posture is good with marginal chin protrusion and slightly protracted R shoulder.

All movements reproduce pain although R lat flexion produces a dull ache in the L trap rather than a sharp pain.

Both L + R traps are tight.

I'm currently working on retractions in supine.

She probably has some active trigger points try scaleni, upper traps and levator scapulae. also supplement with stretching neck in all planes.
Mulligan also describes a good MWM for cervical headaches which the patient can do themselves with a towel- by wrapping the towel just below the occiput and applying a gentle forwards traction as they actively retract.

what is the read up of the patient after retraction's in supine are given? Does the patient have increased pain in loaded position?Also important is,what was the position of the neck when the child decided to swing on it. Since you have already started with retraction,you have already introduced flexion to the upper cervical spine. If this has not given you any positive outcome, try out upper cervical extension, which can be seen by introducing protrusion or by isolated upper cervical extension. Then if necessary see what the movements in the frontal plane are throwing up. The diagnoses could be many, but more info is neccessary regarding the case.