Description. Chiari Malformation (CM) is a group of complex brain abnormalities that affect the area in the lower posterior head where the brain and the spinal cord connect. CM can also cause pressure on the brain and the spinal cord, potentially causing a wide variety of symptoms. The hallmark symptom associated with CM is the occipital headache that can be brought on or worsened by coughing, straining, or sneezing, other symptoms may vary among individuals. The treatment of this condition is directed toward the specific symptoms that are apparent in each individual. If mild symptoms are present such as neck pain or headaches, physicians may recommend conservative treatment. Such as pain medications, massage therapy, or reduction in activities. Under direct patient's doctor’s supervision, massage therapists relieve tight muscles and local fascia with soft to mild pressure. Focusing on muscles that connect the superior neck with the posterior head; the muscles that connect the middle neck with the scapula and shoulders; and the muscles and fascia of the skull. Patients with this condition must not experience stretching technique, twister in the neck, deep tissue in the neck area, and Craniosacral technique, among other manual techniques. However, it may be beneficial to get manual therapies around the shoulders and upper back from myofascial technique and neuromuscular technique.