Dragon’s Medical Bulletin: Case Study feature in March 2011 article

This March 2011 I was invited again to contribute as Features Writer to the widely popular Dragon’s Medical Bulletin. My article offers insights into my understanding and expertise in administering Bowen Therapy

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A Short Case Presentation on Bowen Therapy and Jaw Pain

by Dr. Leila Sahabi

Last February, I met a 35 year-old female in my office who had been suffering from chronic headaches and jaw pain. Let’s call her Nelly for the purpose of this article.

Upon inquiry into her medical concerns, it became apparent that Nelly had had pain in the left side of her jaw for five years, following a very traumatic wisdom teeth extraction. The pain started from the temporomandibular joint (TMJ) and radiated along the left jaw line into the left side of the neck, as well as into the left trapezius muscle. She described the pain as a typical nerve type sensation — shooting and sharp. Nothing seemed to alleviate it except for applying mild to moderate pressure on the left side of the face. This led Nelly to practice continuous ‘jaw clenching’ to help mitigate the pain.

Six months after the extraction, Nelly started to experience severe tension headaches, starting from the back of the neck and going up the back of the head. She described the pain as a dull pressing ache, which was relieved by applying pressure on the skull, such as tightly wrapping the head in a towel. Nelly’s overall health began to decline at this point, as the jaw pain and the headaches became increasingly more frequent and began to interrupt her sleep.

On the day of our initial visit, Nelly stated that she had been having constant jaw pain for five days prior. She felt that an episode of intense headache was imminent. An assessment of suboccipital and neck muscles revealed great tension and hypertonicity. The jaw also opened with a slight lateral shift and an audible click. Nelly said that her entire body, especially her abdomen, seemed to be in great tension.

I chose to address this case primarily using Bowen Therapy. The Bowen Technique is a type of soft-tissue manipulation developed in Geelong, Australia by Thomas A. Bowen (1916- 1982). Bowen believed that the underlying cause of most musculoskeletal problems could be found in the soft tissue. Each treatment of this gentle, yet powerful technique involves a set of hands-on maneuvers on tendons, muscles, and nerves, interrupted by short pauses allow the body to integrate the stimulus received, and to encourage the body to reset and rebalance itself.

The Bowen Technique has a wide variety of indications from acute sports traumas to chronic conditions. In essence, it allows the body’s self-healing energy to thrive, often improving joint mobility and increasing venous and lymphatic circulation. This non-invasive and gentle technique can be used on everyone from infants to the elderly. Nelly’s initial Bowen treatment comprised of a series of maneuvers to relax the entire body, in this case, especially the upper back and the head and neck regions.

At the one week follow-up, she reported an increase of tension in the neck muscles and a slight increase in the intensity of the headache on the day of the treatment, which dramatically subsided the next morning. Nelly felt a 40% percent improvement in the headache and jaw pain within 24 hours.

In the second treatment, I performed the more specific moves on the anterior and posterior neck muscles (sternocleidomastoid and scalenes) and TMJ. This treatment elicited a 60% improvement in intensity of the jaw tension and headache.

A third treatment followed two weeks later, which further improved the TMJ tension and headache by 80%. When I met with Nelly three months after her treatments, and she stated that her jaw pain and clenching were entirely resolved and that she no longer suffered from frequent tension headaches.

She was also able to sleep better as pain did not keep her awake. It is common for tension in the upper trapezius and neck muscles to lead to headaches.These muscles pull on the suboccipital muscles, which in turn pull on the ‘epicranial aponeurosis’ (the broad tendinous layer that covers the top of the scalp extending from the back of the cranium to the forehead).Tension in this tendinous layer contributes to tension headaches.

The Bowen technique helps alleviate headaches by releasing the tension. In Nelly’s case, just three treatments of the Bowen technique were enough to effectively ease her various pains, which were all inter-related and seemingly caused by the trauma to the jaw during the teeth extraction procedure.

So, next time you encounter a patient in your practice with chronic headaches, it may be helpful to assess the TMJ and watch for any lateral deviation or audible sounds while opening or closing the jaw. It is also important to assess the state of the upper body and neck muscles, which often triggers headaches.

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Dr. Leila Sahabi, BSc, ND, received her undergraduate degree in Science and Psychology from the University of British Columbia and her Doctor of Naturopathic Medicine from the Boucher Institute of Naturopathic Medicine. She currently practices at the Richmond Alternative Medical Clinic Inc. in Richmond, BC, with special interests in women’s health and musculoskeletal problems. Besides naturopathy, Dr. Sahabi often incorporates acupuncture, homeopathy, First Line Therapy,™ and Bowen therapy in her patient care. Her website can be found at www.hhnaturopathic.com