iTrac Clinical Case Study 1

Posted by Jarrod Nichols, DC, CSCS on Thursday, November 20, 2014

20 Year Old Female Patient Presenting Symptoms and History of Care:

  • Chronic daily headaches and neck pain
    • Progressive onset, duration of 6-12 months
      • Previous history of occasional (1-2/ week) headaches as a teenager
    • Treatment history included traditional chiropractic manipulative therapy
      • Patient experienced short-term relief
      • Symptoms returned within 1-2 weeks of each treatment

Initial Examination Findings:

  • Headache Disability Index
    • Initial score = 50
  • Ortho/Neuro
    • Palpation revealed active and latent trigger points bilaterally in the suboccipital, levator scapula, SCM and upper trapezius muscles
    • Motion palpation revealed facet joint fixations throughout the cervical and upper thoracic spinal regions
    • Myofascial pain experienced during the following exams:
      • Shoulder depression
      • Soto-Hall
    • Relief experienced during the following exam:
      • Cervical distraction
    • Cervical Ranges of Motion
      • Flexion - 35ºitrac clinical case study 1
      • Extension - 45º
      • Left lateral flexion - 30º
      • Right lateral flexion - 35º
      • Left rotation - 60º
      • Right rotation - 65º
    • Posture Analysis
      • Forward Head Posture
  • X-Ray
    • Roentgenometric evaluation of the lateral cervical x-ray demonstrated:
      • Reversed cervical curve (-13º)
        • (normal avg = 34-42º)
      • Reduced atlas plane line (11º)
        • (normal avg = 29º)
      • Forward Head Posture (27mm)
        • (normal avg = <15mm)


  • 3 treatments/week for 4 weeks = 12 total treatments
  • Trigger point therapy/myofascial release was utilized to reduce active and latent trigger points in the effected muscles
  • Spinal manipulation was utilized to improve spinal ranges of motion and decrease pain
  • The following strengthening exercises and stretches were incorporated to correct abnormal movement patterns in the neck, upper back and shoulders (performed at home once the patient mastered them in the office)
    • Band pull-aparts (scapular/rotator cuff stabilization)
      • 3 sets of 12-15
    • Push up plus (serratus anterior strengthening)
      • 3 sets of 12-15
    • Cervical retractions (strengthening deep neck flexors)
      • 3 sets of 12-15
    • Doorframe stretches (pectorals)
      • 5 sets, 30-45 seconds each
  • The iTrac® Spine Remodeling System was applied to restore the cervical curve and reduce Forward Head Posture

Post-Treatment Examination Findings:

  • Headache Disability Index
    • Post-treatment score = 0 (Initial = 50)
  • Ortho/Neuro
    • Palpation revealed no active or latent trigger points
    • Motion palpation revealed no facet joint fixations in the cervical or upper thoracic spinal regions
    • No myofascial pain was experienced during the following exams
      • Shoulder depression
      • Soto-Hall
    • Cervical Ranges of Motion
      • Flexion - 50º
      • Extension - 60º
      • Left lateral flexion - 50º
      • Right lateral flexion - 50º
      • Left rotation - 85º
      • Right rotation - 85º
    • Posture Analysis
      • Minimal Forward Head Posture
  • X-Ray
    • Roentgenometric evaluation of the lateral cervical x-ray demonstrated:
      • Near normal cervical curve (23º) (initial = -13º)
      • Normal atlas plane line (32°) (initial = 11º)
      • Minimal Forward Head Posture (8mm) (initial = 27mm)

itrac clinical case study 1 pre and post x-rays

About Author

Jarrod Nichols, DC, CSCS

Dr. Jarrod Nichols is a chiropractic physician, entrepreneur and innovator. He received his doctorate from Palmer College of Chiropractic, graduating Magna Cum Laude in 2004. Dr. Nichols opened Nichols Chiropractic in 2005 where continues to treat patients. In 2006, he established Nichols Therapy Systems – an enterprise created to design and develop technologically advanced therapy products aimed at spinal curve & posture restoration. Dr. Nichols trains clinicians worldwide how to successfully integrate iTrac® Spine Remodeling into their clinical protocols.