A few months ago we worked with a patient who had very unusual symptoms. She is a woman in her early 50s who almost a year ago was diagnosed with Essential Tremor of the upper neck just below the occipital ridge and head. The sensations she described were very strange. She felt constant and very rapid muscle contractions on her upper neck and up to her temporal areas, especially on the left. The contractions were so rapid they almost felt like buzzing. These contractions were unnoticeable when she or someone looked on her neck. They bothered her all day long and greatly affected her sleep since they prevented her from falling asleep, even though she could sleep through the night once she fell asleep. All tests were normal.
The patient worked with three neurologists and tried everything from antipsychotic medications to acupuncture with no results. Her last neurologist labeled her condition as Essential Tremor. The presence of the word ‘essential’ in any medical diagnosis means the physician doesn’t have any idea what causes the pathology.
The patient became convinced that her health providers believed that she made up her symptoms since her last neurologist recommended she see a psychiatrist.
When we saw her two weeks ago she seemed heavily sedated, with slower speech and movements.
All commonly used tests we performed were negative. The patient didn’t exhibit any symptoms of sensory or motor deficit. During careful palpation of her neck and temporal muscles there weren’t any symptoms of muscle tremor or rapid contractions felt under the skin.
Since we always examine every possible lead, especially in complicated cases, we decided to examine the pathway of the greater and minor occipital nerves. A Compression Test was negative for the possible irritation of the occipital nerves by the trapezius, semispinalis capitis, and oblique capitis inferior muscles. Suddenly while applying a Compression Test on the obliques capitis superior muscle the patient practically jumped on the table screaming: “That’s it! That’s it! You just made my tremor worse!”
Further detailed examination confirmed that her symptoms were indeed triggered by irritation of the greater occipital nerve by the obliqus capitis superior muscle just below occipital ridge. Five sessions of Medical Massage protocol for Greater Occipital Nerve Neuralgia completely eliminated her symptoms.
There is a humorous end to the story. The patient went to her neurologist for her regular follow up and with great excitement informed the neurologist that she was treated in a Medical Massage clinic and her symptoms were now completely gone. To her great surprise the neurologist got really irritated and told her that patients don’t fully appreciate the work of medical professionals. According to the neurologist, the patient’s symptoms were eliminated not by massage therapy, but by vitamins she prescribed her two months earlier!
LESSONS:
1. The word ‘essential’ in a medical diagnosis means that the therapist has a free ticket to examine symptoms since no cause of the pathology was established.
2. Mild irritation of the occipital nerve by each of four neck muscles may produce common symptoms like occipital headache as well as seemingly completely unrelated symptoms like Cluster Headache, Essential (!!!) Hypertension, Non-Positioned Vertigo, Tinnitus, or even such a bizarre one as Essential Tremor.
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