Osteopathic manipulative treatment and cervicogenic headache: a randomized controlled trial

Area of Science:

• Integrative Medicine
• Neurology
• Musculoskeletal Health

Background:

• Cervicogenic headache (CeH) is a prevalent secondary headache disorder linked to cervical spine dysfunction.
• Understanding effective treatments for CeH is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the efficacy of osteopathic manipulative treatment (OMT) for managing cervicogenic headache (CeH).
• To assess OMT's impact on functional disability and cervical range of motion in CeH patients.

Main Methods:

• A randomized controlled trial involving 413 CeH patients allocated to OMT or placebo groups.
• Primary outcome: Neck Disability Index (NDI); Secondary outcome: Upper cervical rotation via Flexion-Rotation Test (FRT).
• Statistical analysis included two-factor ANOVAs and Cohen's d for effect size calculation.

Main Results:

• The OMT group showed a significant improvement in NDI scores (5.9 points) compared to the placebo group (2.5 points).
• OMT achieved the minimal clinically important difference (MCID) for NDI, indicating meaningful improvement.
• Large effect sizes (Cohen's d=0.74-0.87) were observed in the OMT group, demonstrating substantial impact.

Conclusions:

• Osteopathic manipulative treatment (OMT) effectively reduces pain and enhances functional capacity in cervicogenic headache (CeH) patients.
• Patients presenting with higher initial Neck Disability Index (NDI) scores derive greater benefits from OMT interventions.