Keywords; meningitis, head neck pain, migraine, chiropractic.

A bacterial or viral infection should always be considered in the patient with a stiff neck and headache, simply because it is so serious. Not many patients with infectious illnesses appear in the chiropractor's office, because this patient is sick. It's a highly contagious disease, so the doctor is also at risk.

In hospital the patient will be immediately be placed in isolation. Because we chiropractors treat so many patients with headache, this is a rare but very serious disease that we should keep in the back of our minds whenever treating the patient with a headache and stiff neck.

This is not the typical stiff neck where you can't turn your head to the side, but flexing the head onto the chest is very painful and severely restricted.

The classic test of Kernig is done with the patient lying on their back, with the hips and knees bent in the so called 90 stroke 90 position. If someone supports your thighs, and straightens your knees, and it causes neck pain, then it's definitely time to get to hospital. Not to your doctor, nor to your chiropractor. Do not pass GO, do not collect $200, GO STRAIGHT TO THE HOSPITAL. Remember this illness may be highly infectious. Your family and acquaintances should immediately be alerted.

The condition may be viral or bacterial. In the latter a rash is common.

Meningitis is a medical emergency. Don't mess around with Chiropractic Help!



Severe headache is the most common symptom (87%) followed by neck stiffness 83%.

The classic triad of diagnostic signs are:

  • unable to flex the neck forwards onto the chest
  • sudden high fever (40 degrees C) and
  • altered mental status. This patient is Sick! with a capital S.

JOHANNESBURG. The Natal Witness, 25th May, 2010.

Tenor Siphiwo Ntshebe, who was to sing Hope at the World Football Cup opening ceremony, died in Port Elizabeth on Tuesday, his record company announced yesterday.

Within a week of realising his dreams of performing at the opening of the WFC he was struck down with the meningitis bug. It's a great sadness, said Sony's chief executive officer, Keith Lister.

Ntshebe, aged only thirty four, and dubbed South Africa's new Pavarotti had just finished recording an album when he was smitten by the bacterial meningitis bug.

A Sony spokesman said the Hope recording was still on the official WFC program. They hadn't yet decided what to do about Siphiwo's album.

Here's a tidbit from the chiropractic coalface. For years I had a weekly date with a good friend at the squash court. He has a spondylolysthesis, a low back condition that required occasional visits to my couch. We knocked a few kilos off after work, added a few more back with a couple beers, and generally shot the breeze. We were also both BMW motorcycle fans, and enjoyed a few rides together. One day he didn't arrive for our match. It was not like him. He phoned the next day to apologise, telling me his better half was in hospital with a very stiff neck.

In hospital? Why not in my office? I asked foolishly.

She died three days later. A teacher, she caught the bug from a child who survived. Has your child or partner got a headache, stiff neck, high temperature and isconfused? Don't mess with it.

These layers of tissues are the meninges that form the covering of the brain and spinal cord. Here you can see them peeled back during an autopsy of a patient who died from meningitis. Can you see the little bleeds where blood vessels have ruptured? This patient certainly had head neck pain.

The meninges extend from the brain right down to the low back, covering the brain and spinal cord. That is why in Kernig's test, straightening the legs stretches the meninges and reproduces the neck pain.

In a slipped disk in the lower back something similar happens, but without the infection. If flexing your head forward onto your chest causes low back pain, you have no fever or stiff neck, then make an appointment today with your chiropractor. 


"Let me tell you the secret that has led me to my goal. My strength lies in my tenacity."

Louis Pasteur

Vaccinations remain a vexed subject in the Chiropractic profession, and I confess I have no strong opinion. That they sometimes cause death and disability is beyond debate. Just recently three healthy babies in the Netherlands died in one week, within ten days of having a vaccination against meningitis. However vaccinations also save many lives and we live today in a world without small pox thanks to Louis Pasteur. Headache and a fever? This is probably not headache chiropractic. Stiff neck with it? Get to the emergency rooms NOW.

Head Neck Pain

Two of the symptoms of meningitis are an every day finding at the Chiropractic Coalface; namely neck pain and headache. 

The difference is the high temperature and that it's neck flexion that is particularly limited which is a less common finding.

Errors of judgement are often made when a disease is not yet in its full blown state. In this case, when the patient has only a slightly raised temerature, perhaps.



The sudden death of my friend's wife certainly shocked me, and her death in some ways never left me. One of those ongoing life's reflections.

Ultimately, I decided to use her story in my fourth book, now pending. Santie Veenstra, only twelve years old, suddenly loses her mother to meningitis with tragic consequences for her life. Until she meets Janet Twycross.

Actually it's a trilogy, and the first book you can sample for free at A Family Affair. It's a bit shocking; get ready to be challenged.


Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.

Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Mrs T looked like the leaning tower of Pisa; she had a slipped disc at L5 making her lean towards the opposite side. It's called the postero lateral disc hernia; she's much better after two weeks of treatment and will go back to work next week, part time. Lateral discs are more difficult; both take a minimum of six weeks to heal. In my opinion, antalgic patients need what I call exercising bed rest. Sit and it won't get better.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months. He has a pincer deformity in the hip causing the groin pain, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your lower back is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her hip, knee and ankle issues. Xrays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Hypermobility is more difficult that too stiff in my opinion. Chiropractic is for kids too.

8. This 65 year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88 year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done.  

10. Mr X is a 71 year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a year ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he couldn't sleep on that shoulder.

13. Mr D, a 71 year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.