Considering the patient’s feeling that the headaches begin in her neck and shoulders, a complete evaluation of her cervical spine, thoracic spine and bilateral shoulders would be advised. Also, important to consider are bilateral TMJ and Craniopathy evaluations.

This patient’s cervical spine had fixations in the upper and lower cervical spine as well as her upper posterior ribs. There were spasms in the trapezius muscles bilaterally as well as SCMs and suboccipital muscles. The trapezius was so contracted that the scapulae were chronically elevated and there was an overuse of the levator scapulae bilaterally. This patient had bilateral TMJ dysfunctions with spasms of the masseters and pterygoids. She carries her head in a retracted posture. Cranial faults were evident.

Question: What is your working diagnosis at this point?