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Case ref:201905636
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Date:November 2020
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Body:Grampian NHS Board
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Sector:Health
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Outcome:Not upheld, no recommendations
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Subject:clinical treatment / diagnosis
Summary
C complained that the board failed properly to investigate the causes of their neck and shoulder pain. As a result, they said that they experienced up to 20 migraines a month and spent a large part of time in bed. C said that they regularly asked for an x-ray but were told that it would not be appropriate and were prescribed a number of medications and botox, none of which had effect. Because they were struggling with their quality of life, C attended a private chiropractor (a person who treats diseases by pressing a person's joints, especially those in the back) who took x-rays which revealed that the vertebrae at the top of their spine were out of alignment. The chiropractor then carried out a procedure to address this, as a consequence of which, C said, their migraines largely disappeared.
C believed that the board ignored their concerns about neck and shoulder pain and said that had they been addressed when requested, they would have had a better quality of life.
The board’s view was that, throughout, C had been treated appropriately and in line with clinical guidance; x-rays were not normally recommended in migraine diagnosis and management and were not standard practice. They also said that clinicians were not trained in alternative procedures and were unable to recommend them.
We took independent clinical advice. We found that x-rays were not part of the normal practice in the diagnosis and management of migraine and that neck and shoulder pain can occur in 90% of patients with migraine. We also found that the alternative procedure given to C was not an approach offered by the NHS and that C had been treated in line with clinical best practice. We did not uphold the complaint.