Miss F, a 36 years old career-driven lady, presented on Nov/2003 complaining of neck and top of shoulder pains as well as headaches to the back, sides and front of the skull.

She described the pain as tense and seized-up in the neck and shoulders with constant dull headache which sometimes woke her up in the early hours of the morning. The symptoms began a few weeks earlier after a road traffic accident when she was hit from behind. No other symptoms were revealed on further questioning.

A detailed examination of her neck, upper back, upper limbs reflexes, muscle strength and range of motion revealed tight muscles and restricted joints, especially at the base of the skull and top of shoulders. This is typical of neck injuries after a road traffic accident, which usually results in (over) stretching and compression forces of the driver’s head, straining muscles and joints.

Pain or discomfort does not always occur immediately after the road traffic accident; in fact, it may take months for the symptoms to develop as the type of pain this patient suffered.

The management plan for this patient was a course chiropractic manipulations, gentle passive stretches and muscle techniques, advice on how to use ice packs to decrease pain as well as specific exercises.

She felt “much better” by the second treatment and gradually improved over the next few months. She only visits the clinic for yearly treatment.