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A randomized controlled trial of the effect of spinal manipulation in the treatment of cervicogenic headache
1Nordic Institute of Chiropractic, Odense, Denmark.
Purpose:
To determine whether the isolated intervention of high-velocity, low-amplitude spinal manipulation in the cervical spine has any effect on cervicogenic headache.
Design:
Randomized controlled trial with a blind observer.
Setting:
Ambulatory outpatient facility in an independent NHS-funded chiropractic research institution.
Participants:
Thirty-nine subjects suffering from frequent headaches who fulfilled the IHS criteria for cervicogenic headache (excluding radiological criteria). These subjects were recruited from among some 400 headache sufferers who responded to newspaper advertisements.
Intervention:
Half of the group received high-velocity, low-amplitude cervical manipulation twice/wk for 3 wk. The other half received low-level laser in the upper cervical region and deep friction massage (including trigger points) in the lower cervical/upper thoracic region, also twice/wk for 3 wk.
Main Outcome Measure:
The change from week 2 to week 6 in analgesics use per day, headache intensity per episode and number of headache hr per day.
Results:
Despite a significant reduction in the manipulation group on all three outcome measures, differences between the two treatment groups failed to reach statistical significance.
Conclusion:
The results suggest a possible effect of manipulation on cervicogenic headache, but because of methodological problems, such an effect could not be unequivocally demonstrated.