A randomized controlled trial of the effect of spinal manipulation in the treatment of cervicogenic headache.
OBJECTIVE
To determine whether the isolated intervention of high-velocity, low-amplitude spinal manipulation in the cervical spine has any effect on cervicogenic headache.


METHODS
Randomized controlled trial with a blind observer.


METHODS
Ambulatory outpatient facility in an independent NHS-funded chiropractic research institution.


METHODS
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.


METHODS
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.


METHODS
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.


CONCLUSIONS
The results suggest a possible effect of manipulation on cervicogenic headache, but because of methodological problems, such an effect could not be unequivocally demonstrated.
Nilsson
N
N
Nordic Institute of Chiropractic, Odense, Denmark.
D000328:Adult; D002574:Cervical Vertebrae; D004311:Double-Blind Method; D005260:Female; D006261:Headache / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008349:Manipulation, Orthopedic / Q000379:methods; D008875:Middle Aged; D013122:Spinal Diseases / Q000150:complications / Q000503:physiopathology; D016896:Treatment Outcome