American Headache Institute
Head, Neck, & Facial Pain
Treatment Centers
Treatment can not begin without a thorough 
history and physical examination of the cervical spine

                                  OUR EXAMINATION                                           OUR RESEARCH SUPPORT
                                                                               (Direct Quotes)
  • We look where others do not – the neck.
  • A safe, meticulous examination of the neck reveals pain
  relieving positions and movements.
  • Invasive testing such as x-ray, CT scan, MRI, or injections,
  performed by others, are not repeated here.

Call Us
(248) 841-1543
Thought of your neck?
We Have!

M.  Nordin, Dr Med Sc   Assessment of Neck Pain and Its Associated Disorders:  (359 articles  reviewed, 95 admissible)  “There was no evidence that specific MRI findings are associated with neck pain, cervicogenic headache, or whiplash
exposure.  No evidence supports using cervical provocative discography, anesthetic
facet, or medial branch blocks in evaluating neck pain. There is support for subjective self-report in monitoring a patients’ response to treatment”.
(Spine 2008;33:4S,S1-S220).

For more than 3 decades, we have learned the most
insightful questions to ask, and the most relevant tests
                      to perform on your first visit.  Our in-depth
                      series of historical questions often exposes
                      the cervical spines’ involvement.  Our
                      highly specific, meticulously designed
examination of neck positions and subtle movements 
is capable of bringing about a surprising decrease or
abolishment in head and facial symptoms. 
The vast majority of new patients experi-
ence a significant alteration of their symp-
toms during the examination with over
40% reporting a complete abolishment.  In as few as
1-3 visits, the role your cervical spine may play is best
answered when controlled repositioning of your neck
brings about significant changes in your symptoms. 

P. Rothbart, MD,  Medical Director, Rothbart Pain
Management Clinic, Toronto, Ontario..
“Approximately 800 new headache patients per year are examined at our clinic.  An estimated 80% of these patients are diagnosed with cervicogenic headache.  Of these patients almost none are referred with this diagnosis”.
“Physicians are not taught to consider or explore neck structures when investi-
gating headaches.  This results
in a rarely diagnosed but common
condition”, says Dr. Rothbart.

As Dr. Nordin states above, there is scientific support for
“subjective self-report” by the patient in monitoring 
symptom response during examination and treatment. 
We invented an examination process for head and facial
symptoms which we call “Centralization Analysis”.  It
relies on patient self-report.

Here’s How It Works
your symptoms
are coming from your neck,
the American Headache Institute
has discovered which symptoms will abolish first,
second, third, and so on, starting with zone 10 (mouth).  We  call this “Centralization”.   Once all of your head  and facial symptoms have been identified in the 10 symptom zones below, your cervical treatment program is aimed
at reducing  and  abolishing  the symptom  which is
farthest from your neck.  Watching your face and

A.  Chorti, MSc   The Prognostic Value of Symptom Response in the Conservative Management of Spinal Pain: “Only for changes in pain location and/or intensity with repeated spinal movement testing (Centralization) or in response to treatment did the data provide support for use of symptom response to inform management”.
(Spine 2009;34:2686-2699).

M.  Werneke, MS, PT, Dip MDT  A Descriptive Study of the Centralization Phenomenon:  A Prospective Analysis  “Categorization by changes in pain location to mechanical assessment and treatment allowed identification of patients with improved treatment outcomes and facilitated planning of conservative treatment of patients with acute back and neck pain syndromes”.
(Spine 1999;24:676-683).

head  symptoms  dissipate  in  a predictive,
predetermined,  and  orderly  fashion,  is
our unique clinical discovery and our big
treatment  advantage.  Together,  we 
observe your centralizing symptoms
which  demonstrates  the  necks’
involvement and reassures us 
that the treatment is both
correct and effective.

N. Bogduk, PhD   Anatomy and Physiology of Headache“Because of its prevalence, every physician has a responsibility to be able to assess headaches: either to identify headaches they can manage themselves, or those that require referral.  Ultimately headache may require specialist investigation and management”.
(Biomed & Pharmacother 1995;49:435-45).

B. Mark, DDS  Cervicogenic Headache Differential Diagnosis and Clinical Management: Literature Review “The cervical spine must be evaluated to rule out cervical spine dysfunction with patients who have symptoms in the craniocervical-mandibular region”.
(J Craniomandibular Practice 1990; 8:332-38).

M. Gallagher, MD  Cervicogenic Headache; A Special ReportEvaluation of the neck, determining its role in the patient’s headache problem, establishing a working diagnosis and including the neck in the treatment plan, regardless of diagnosis, is the most helpful
for both patient and physician”.
(Neurotherapeutics 2007;7:
Suboccipital &
Upper Cervical
(Zone 1)
(Zone 10)
F. Antonaci, MD  Diagnosing Cervicogenic Headache. 
“Differential diagnosis is sometimes a challenge and kinematic (movement) analysis of neck motion may aid in diagnosing”.
(J Headache Pain 2006;

For decades, physicians and dentists have known the cervical spine can refer pain into the head, jaw, and face.  And until now, there was little known about how to treat such a neck problem.  Focused exclusively on the neck, your treatment program is individually tailored in 4 specific areas;

1. Pain Relieving Exercise (PREP)   
2. Posture Correction    

3. Education     

4. Neuromuscular Reeducation

Centralization of Head Symptoms
Order of Symptom Abolishment
S. Haldeman, MD, PhD, DC,
President,  Neck Task Force Report
“Treatment  involving  exercise,   manual  therapy,
educational interventions, and patient self-efficacy
are  more  effective  than  alternative strategies for
patients with neck pain”.
(Spine 2008;33:4S,S1-S220)

(Direct Quotes)