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The overlap in signs and symptoms between CGH, tension-type headaches and migraine headaches complicate the differential diagnosis. Furthermore, poor outcomes for CGH with conventional pharmacology is not uncommon. Adolescents presenting with cephalgia should be screened appropriately for cervical etiology. Evidence supports the use of upper cervical spinal manipulation and dry needling for the treatment of CGH in the adult population. However, there is a lack of evidence supporting the diagnosis and treatment of CGH in adolescents. This case report describes the clinical diagnosis and successful management of a 16-year-old female with chronic, frequent episodic CGH that was refractory to polypharmacy. The patient was able to stop taking all medication for her headaches and reported resolution of pain and disability, following 4-weeks of upper-cervical spine thrust manipulation and electrical dry needling.<\/jats:p>","DOI":"10.1177\/30502225261490267","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:06:15Z","timestamp":1789020375000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Resolution of Refractory Headache Symptoms Following Cervical Spinal Manipulation and Electrical Dry Needling in an Adolescent Female: A Case Report"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6559-993X","authenticated-orcid":false,"given":"Ian","family":"Young","sequence":"first","affiliation":[{"name":"American Academy of Manipulative Therapy Fellowship, Orthopaedic Manual Physical Therapy"},{"name":"Tybee Wellness & Osteopractic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April","family":"Martino","sequence":"additional","affiliation":[{"name":"Butler University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1194-0108","authenticated-orcid":false,"given":"James","family":"Dunning","sequence":"additional","affiliation":[{"name":"American Academy of Manipulative Therapy Fellowship, Orthopaedic Manual Physical Therapy"},{"name":"Montgomery Osteopractic Physical Therapy & Acupuncture"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Prall","sequence":"additional","affiliation":[{"name":"American Academy of Manipulative Therapy Fellowship, Orthopaedic Manual Physical Therapy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Escaloni","sequence":"additional","affiliation":[{"name":"American Academy of Manipulative Therapy Fellowship, Orthopaedic Manual Physical Therapy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firas","family":"Mourad","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Campus Bio-Medico di Roma"},{"name":"LUNEX University of Applied Sciences"},{"name":"Luxembourg Health & Sport Sciences Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102412454226"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.23736\/s2724-5276.21.06191-7"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-001-0030-1"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-023-01634-w"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.1998.3806442.x"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-8749.2010.03793.x"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756285615616586"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/03331024251413283"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0404.2007.00962.x"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm15052084"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.70219"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2020.10.008"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l1476"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102418772584"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.57.11.2034"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1054\/math.2000.0234"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10194-010-0222-3"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-016-0912-3"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413485658"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.62087\/hpr.2024.0004"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102499019s2503"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzad154"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-025-02855-7"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2009.08.004"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11655-017-2789-x"},{"issue":"2","key":"e_1_3_7_27_2","first-page":"115","article-title":"[Effects of electroacupuncture on synovia IL-1beta and TNF-alpha contents in the rabbit with knee osteoarthritis]","volume":"32","author":"Huang J","year":"2007","unstructured":"Huang J, Zhuo LS, Wang YY, et al. 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