Accident as a likely cause of the symptoms described below:

• Fall while skiing, previously no complaints
• First severe neck and back pain about 10 hours after falling
• Development of the full complaints gradually over the following 6 weeks

I reported the following symptoms (Cervical syndrome):

• Nape and back pain
• Very „constrictive“ headache
• At times, a feeling of not being really „there“, no clear separation between self and the environment (very stressful!!!)
• Myogelosis in the nape and shoulder region
• Muscle tension up to spasms in the occipital region
• Sometimes for a while (minutes to hours) blurred vision
• Personal insecurity up to temporary states of anxiety
• Claustrophobia (no driving in tunnels, no elevator, no small rooms, etc.)
• Strongly reduced physical performance (no more than 20%: Climbing a staircase to the second floor already results in exhaustion, sweat on the forehead quickly, after a few hours of concentrated work office already exhausted, travelling is barely possible to impossible
• Increased irritability, increased sensitivity to noise
• Insomnia, including problems with darkness
• temporary tingling, sensation of numbness in the arms and fingers
• As a result: Depression-like symptoms, dejectedness, discouragement also because of the discrepancy between the examination results which yielded no findings and the poor condition
• As a result: Potential risk of being considered, by adherents of orthodox medicine and possibly also by employers etc., as a malingerer (was not a problem for me, however, since I am self-employed as an independent entrepreneur)

Comprehensive medical examinations without any findings (odyssey of 4 months):

• X-rays, MRI imaging, orthopaedics and many others, without any findings.
• Orthodox medicine was unable to provide any diagnosis for the symptoms – helplessness results
• „… you will have to live with that … “
• I could not accept this „result” and my poor condition, and thus I spent many hours researching the Internet and medical books (details described below). This was successful (see details below).

The way to find help: Diagnosis, treatment and results

• Consultation of a skilled manual therapist (see details below)
• The examination yields the diagnosis „head joint blockage“, and the symptoms mentioned above match this
• The blockage was removed directly after the consultation for diagnosis
• Immediate and abrupt improvement of my condition; residual symptoms gradually faded away during approximately 8 weeks and finally disappeared completely
• Thus I was cured, and I can confirm this more than 6 months later, too.

Below I have described in detail my experience regarding the search for help and the success in terms of diagnosis and treatment finally achieved, as in my search on the Web such a case study might have helped me to find the way to help more quickly.

History: „He has washed his head and put it into the right place“
This linguistic relic can be traced back to the 17th century. Cervical symptoms are not an invention of our days, and there are centuries of successful empirical treatment. This meant the art of eliminating, with targeted manoeuvres on the upper cervical (neck) spine, headache, blurred vision, dizziness, tinnitus, etc., often abruptly (Source: „Die obere Halswirbelsäule“, Dr. Wolff, Hülse, Neuhuber, see references below).

Notes: The information on this page is based on my own experience as a former sufferer and may not be considered as professional medical advice, as I am a medical layman. Luckily, I am literate and can search the Internet and books in search of solutions to a complex problem. The facts are presented here to the best of my knowledge, and I believe that my directions and my cautious advice are sensible and appropriate. On the other hand, however, I want this to be understood merely as a suggestion for a personal individual strategy. I cannot provide any recommendations. My case is certainly only a single one from a very broad spectrum of this complex issue.

Acknowledgements: This comment is intended as an example of an affected person for similar situations and is intended to show a possibly useful way to find help, since orthodox medicine was unable to help me in any way. However, the eliminative method (clarifying what I did not have) was applied quite comprehensively and with great care. Therefore I am grateful to all persons who have occupied themselves with my problem, and I hope that this report will provide a constructive contribution to the general public. No one should feel criticized. All doctors involved were very dedicated. The error rather seems to be, from my layman’s perspective, inherent in the system of medical education. I will analyze this aspect further.

Learning and improving: We need to remain open-minded for learning, also from the experiences of affected persons. Certainly, that can be demanded of all physicians regardless of their individual specialties. The principle of „he who heals is right” must be honoured, and people seeking help do come for healing and relief.

Cooperation: My particular hope lies in the fact that not only affected persons, but perhaps the one or other physician, especially orthopaedic surgeons, neurologists and radiologists (CT / MRI specialists), will understand the potential of manual therapy, and will also direct appropriate patients thither for examination. This is exactly what I, as a layman, had to work out for myself, and it was only with very good luck that I finally found the right way.


History: Before December 26th, 2008, I was completely asymptomatic. In the decades before, I had hardly ever been sick or injured, in spite of maximum commitment as an independent entrepreneur. This information about the original state before the patient career described below is intended to serve only as background.

Course: Fall on December 26th, 2008, as the probable cause, development of the complaints, then the following odyssey through orthodox medicine until correct diagnosis and successful treatment on June 18th, 2009. Experiences 6 months and more after successful treatment.

Fall: I fell quite abruptly when skiing on a sheet of ice, so there remained no time for bracing the muscles or other reactions. My occiput struck the ice. From my perspective, the neck muscles had no chance against that. I had no pain, everything was mobile, so at first I classified the fall as completely harmless.

Initial complaints: Initial discomfort arose the next morning after getting up, i.e. about 10 – 14 hours after the fall (time delayed), as „very severe muscle pain in the back of the head, throbbing and transverse“. I was no longer able to do skiing because my whole well-being was affected. In addition to the pain and spasms in the nape and occiput region, for the first time there was claustrophobia in the relatively small hotel room, which I had never known before. Therefore I travelled home on the very same day. Uncertainty took hold of me. These massive occipital pains with the throbbing sharp pain gradually abated during the next days, but there remained a feeling of pressure in the nape („neck grip sensation“), occipital pain, head as if it were in a vise with muscle spasms in the nape and also in the head area. Something must have happened, because never before had I had neck pain, in spite of office work and long journeys by car. But I had no idea about it and would not take it seriously.

Development of the condition: In January and until mid-February 2009, I continued to work on without restraint for 80 hours per week, as I had done in the years before. My physical and mental concentration and stamina (energy) deteriorated day by day, and the symptoms (neck pain) and claustrophobia (no tunnels, no elevator in the hotel etc.) increased from week to week. After several weeks, approximately the poor condition had been reached which I report for February through about April.

A nadir: On February 10th, 2009, after an over-stressful journey the all-time low was reached: Eating was not possible, and there were sweating, visual disturbances (very blurred vision) and anxiety (but: that would never come back so massively, may have been the panic because at that moment I was still very inexperienced with the condition). Then begin of the pilgrimage to various doctors, as summarized below.

Medical examinations from mid-February to mid-June 2009 (4 months): Family doctor (blood test normal, myogelosis diagnosed), orthopaedist (X-ray yielded no findings; mobility study without relevant results except for blockages in the central spine, which could not be responsible for my condition), neurologist (nerve function without any pathological findings, neurologist wanted to treat me for depression, which have I refused), MRI and CT (without pathological findings: „No structural problems“). Ultrasound examination of the abdomen (no pathological findings), pulmonary examination (no pathological findings). Many visits to the orthopaedist’s, but without any result. There the image of the stubborn guy stuck to me. But I have been lucky that I went on on my own and was able to find help.

Blessing in disguise: Being self-employed, I was able to have my time freely at my disposal, and I barely worked any more. This was followed by more than 30 visits to physician, see above. An employee would have hardly been able to do this, since my poor condition did not at all match the examination results (no findings). And being known to be a keen and independent worker, no one accused me of malingering. But there was something unspoken in the air. In any case, I was inconvenient, became a nuisance – I had the feeling … „nothing to be done” … that had become the result of the medical examinations.

I was determined to continue „troubleshooting” on my own. But more on that later. A „normal” worker would, in my opinion, have come under pressure also professionally in addition to his condition, which would have certainly increased the fears further. I see very clearly the risk of being branded as work-shy.

Further course: Almost permanently strong sensation of tension from the centre of the nape radiating to the back, intensity changing from day to day, sometimes from hour to hour. After the all-time low on February 10th, the panic-like spasms in the back of the head subside (but are still strong and frightening), maybe there is slight improvement of the condition because I have gotten used to the discomfort a little bit – at least I am not so much surprised and shocked any more. Have read quite a lot on the Internet (myogelosis etc). Dealing with the condition may become easier through better understanding, reducing the anxiety. I clarify for myself all the terms that I find in the medical reports. Of course, I do have all the reports!

As a recommendation at this point: BECOME ACTIVE ON YOUR OWN!

First measures: Sleep with the light on because of space problems. Sometimes I used to take a Prontopyrin® (paracetamol + caffeine) or Thomapyrin® tablet (paracetamol + caffeine + ASS), which also had tranquilizing effects and helped me to sleep. Every night was a challenge, and I was relieved when it was daylight again. It was hard for me to stand the darkness. Travel had become impossible. For the worst case, I always had a Tavor® tablet with me (lorazepam). Just for emergencies. I took it only before the MRI examination, because of claustrophobia in the tube. This drug is a killer and may be used only after consultation with the doctor, but in case of an emergency it does provide some 6 – 8 hours of rest and relaxation. In this problem phase it is also reassuring to have such a thing ready for emergencies! I always tried to take no more pills than were necessary.

Lifestyle adjustments and the quest for relaxation:

• Every day I take about 15-20 minutes of gymnastic exercises to strengthen my nape and back muscles. A person with a similar history helps me to do the exercises correctly.
• Talk to people who have been gone through similar things.
• Mentally: Look for solution coming out of myself; seek for advice/experience; do not wait for solutions from „outside“. Have overcome the fears and am very confident since improvement began on 26 May following the „positioning of the vertebrae” plus exercises. Have a clear mind again.

Positioning of the vertebrae provides relief: In mid-May 2009 I had a treatment at a highly esteemed local practitioner’s who very carefully pressed the vertebrae in my back and lower neck area into position with the thumb (NOT THE UPPER CERVICAL SPINE, HOWEVER). Slight crackling noises were heard. This had a positive effect on my condition. In combination with the daily exercises, there has been continuous improvement since this treatment (positive effect of the exercises according to my subjective assessment, I have no evidence for it). The sensation of the „neck grip” is only slightly and not always present, the neck and head pain have greatly decreased and sometimes completely disappear (as long as I am not overstraining myself!). In combination with the now clearer mind and clearer vision too it is easier to find peace and relaxation. Worries and fears have decreased considerably, I do not have fears any more. Being able to sleep soundly and eat with appetite also contributes significantly to better well-being.

My „optimal” environment and kind support by everybody made many things easier for me!

However: My stamina is still low (only about 30% of the temporal perseverance before the fall). After 3-5 hours of concentrated mixed office work, which is kept quite without stress, exhaustion effects begin. I must then lie down for 15-60 minutes. Business trips and project work on site are thus not possible – the last business trip was in mid-March 2009.

I still have constrictive headaches, albeit significantly alleviated. My performance is still very limited. Something isn’t okay with me yet, I feel it very clearly. And thus I continue to search on the Internet and in books. A very good idea!!!

The symptoms I report are: see the top of the page in the Abstract

I ask all those who have to deal with these things most urgently to discriminate between „cause” and „effects”. The muscle spasms were not the cause of my condition, but a result of the head joint blockage which was diagnosed only later. A neurologist wanted to treat me for depression. Where might I have ended up with that?. Of course I was dejected after months of constricting headaches and other associated symptoms in combination with the fact that all examinations seemed to show that I was perfectly healthy. Everything just fantasy, or what? There you grow afraid what’s up with you, don’t you?

Internet search leads me to an experienced manual therapist:
Since orthodox medicine had suggested that I should learn to live with my condition, I began to perform Internet searches for many evenings. And I came across topics such as „cervical spine whiplash“, „whiplash syndrome” and the „cervical syndrome” or more simply the subject of „dysfunctions of the upper cervical spine area”, where the symptoms described were very similar to mine (see above).

Thanks to the book I find the way to the practice of Dr. Michael Graf:

Dr. Michael Graf
Specialist for Physiotherapy and Rehabilitation Medicine
Gartenfeldstrasse 6
D-54295 Trier
Practice phone: +49 / 651 / 755 14

Overcoming the fears: I want to encourage the reader just to ring up these sympathetic and professional people in order to discuss the course of action. Many people in search of help are deeply afraid and no longer dare to consult any doctor. Let me say that you can begin by just getting examined manually, since there is no risk in that. Then on the basis of the diagnosis, if applicable, you can still decide, unhurriedly, about a treatment. That’s the way I did it after consultation with Dr. Graf.

Please don’t be afraid of costs either. Of course, you have to pay privately for such an examination and treatment, but these specialists will take a lot of their time for discussion, examination and treatment, including physical therapy and preparatory physiotherapeutic treatment of the muscles. This is not possible with 10-minute „medicare medicine“. At last, somebody will listen quietly to all your details. Ideally, prepare notes about your ordeal before. And bring along at least 3 hours of time for an examination, because it shall all be done without any hassle. I always went to Trier on the night before the appointment (had someone drive me because alone I was not even able to drive any more!) and I stayed for the night in the hotel so I could go to the practice the next morning as rested and unstressed as possible because, without any exaggeration, I was in a poor overall condition. The entire treatment including the follow-ups proved to be cheaper than the travel and hotel costs – just to avoid giving any numbers. Forget the cost issue, because it is irrelevant. Think about your chance that you can possibly be helped essentially and quickly.

Visit to the practice of Dr. Michael Graf (mid-June 2009):
After telephone contact, an appointment in Trier is quickly made. I would have travelled halfway around the world to seize the opportunity. My instincts told me so, I cannot claim to have „known“. The symptoms in these two books just matched so precisely my (then!) problems that are now history for me.
After an interview of more than half an hour and presentation of my „patient log” (since March 2009 I had written down everything that I undertook in the matter and created a folder with all documents – I can only recommend doing that). There followed about two hours of examination and physiotherapy treatment to soften the neck muscles. Application of warmth, very cautious finger massage on the occipital ligaments, rest. Then there followed a detailed examination with specific manual tests, the mobility of the cervical spine and, finally, the manual examination of the function of the joints of the upper cervical spine.

When examining the mobility of the joint head, Dr. Graf struck gold:

My head joint was blocked.

An urgent request: From my absolutely personal point of view I have to say that the orthopaedist had also examined my head mobility months before, but he had not diagnosed a head joint blockage. From this I, as an ignorant layman, may conclude that this investigation must be performed by specialists in order to recognize such a functional impairment if it is actually present. Or if it is suspected: Please direct the patient for investigation to doctors who are capable of doing that.

We decided after joint consultation to immediately address the treatment, i.e. the removal of the blockage. With a sure grip, the head joint blockage was loosened with a little impulse and a slight crackling sound. „That should have done it…” – that were the dry words of the expert. I tried to move my head. It felt quite different from before, I had never felt my head moving so lightly into all possible directions. Nodding and throwing the head back (flexion and anteflexion movements which should come from the head joint and not from the cervical vertebrae) was now quite easy. A great feeling. Also, my vision was suddenly sharper, as if a grey curtain had been pulled away from before my eyes. I was a different person. Head held high, I walked around and I immediately had the secure feeling that my health problem had been tackled at its root and solved. To this present day, more than 6 months after the treatment, this has proven true.

Briefly: Then every day I did the exercises discussed, particularly head movement exercises. Especially the „tortoise” – there you move your head in the head joint (nod down – then slowly move up the head to the neck). Initially I still felt slight pain when moving the back to the stop of the joint. In the following weeks this abated more and more. About 10 weeks later, I was completely cured with regard to the cervical spine problem, and since then I have not felt my nape at all, just as it was before the fall, too.

However, I have changed my life and learned from the problem.

Lesson Learned: One must be able do with less travelling. Organize instead of trying to do everything for yourself. Leisure and plenty of physical exercise. Have fun and be thankful too. Set up a website with the experiences in the hope that it may help other people. I have learned a lot from these events. Maybe it saved me from something worse. And I met great people, especially in Trier.

Internet and literature references: First, I was lucky to discover the books by Dr. Wolff and Dr. Graf. See the two references provided below. The books are at least partially comprehensible for laypersons as well (with limitations). „At any rate you come back with more than with what you left…” – so pluck up your courage for a medical book!

First, I want to draw your attention to the website of the healer Elmar Schürr (www.elmar-schuerr.de) where the subject of „Atlas blockage / head joint blockage – unrecognized cause of many conditions” (German: „Atlasblockade / Kopfgelenkblockade – verkannte Ursache vieler Erkrankungen“) is presented in a form comprehensible for laypersons.

„Die obere Halswirbelsäule: Pathophysiologie und Klinik“, authors: Hülse, Neuhuber, Wolff (ISBN-10: 3-540-25605-9); Springer Verlag 2005

„Beschleunigungsverletzung der Halswirbelsäule (HWS-Schleudertrauma)”, editor: M. Graf, C. Grill, H.-D. Wedig; Steinkopf Verlag 2009 (ISBN: 978-3-7985-1837-7)


The plethora of information about various complaints emanating from the cervical spine, especially from the upper cervical spine, makes it difficult for the individual patient to find the right way to a „knowing and able” physician and thus to correct diagnosis and treatment. By „right” I mean a real diagnosis of the true cause of the problems and not the diagnosis of their various effects.

This report from my perspective as a formerly affected person for other affected persons who are in a similar situation (or may know persons where this is the case), as I have described it, is intended to show the way for manual therapy concerning the „cervical syndrome“ and also to encourage. It was not „orthodox medicine” which showed me the way; comprehensive independent studies on the Internet and in books found there did.

If your doctor (your doctors, such as family doctor, orthopaedist, neurologist) have „explained” to you that you must learn to live with the above complaints, do not accept this as the last word in this matter. Such „advice” may reflect only the ignorance of the medical profession in general and of your doctor in particular, as my own patient career shows. Also a CT or MRI examination could only exclude „structural problems” but provide no indications of the present head joint blockage. You must know that such a blockage cannot be identified by „imaging“!

From my point of view, an examination (this is not a treatment yet!) by a suitable manual therapist in order to determine whether a head joint blockage or other dysfunction in the upper cervical spine is present in your case is advisable if the symptoms are the same as in my case, especially when it’s „end of the line” for orthodox medicine. Certainly also in many other cases which I do not know about. Being a layman, I cannot make any statements relating to cases other than the symptoms described here.

The manual examination, the detailed discussion and understanding and ultimately the removal of my head joint blockage on June 18th, 2009, by Dr. Graf (manual therapist in Trier) have brought me back from real suffering and despair to untroubled life and given me back my full ability and performance. I just cannot be grateful enough. This comment is therefore to be understood also as my way of expressing my gratitude to the general public.

If you are looking for contact to a suitable manual therapist closer to your home, then just ring up the practice in Trier to ask. They will by glad to help you.

Practice of Dr. Michael Graf, Gartenfeldstraße 6, D-54295 Trier. Phone +49 / 651 / 75514.


All statements on this page are based entirely on my own personal experience and cannot be construed as qualified medical advice. In no case shall I be held responsible or liable for any consequences.