title: The effect of spinal manipulation in the treatment of cervicogenic headache.
abstract: OBJECTIVE
  To study whether the isolated intervention of high-speed, low-amplitude spinal manipulation in the cervical spine has any effect on cervicogenic headache.
  
  
  METHODS
  Prospective randomized controlled trial with a blinded observer.
  
  
  METHODS
  Ambulatory outpatient facility in an independent research institution.
  
  
  METHODS
  Fifty-three subjects suffering from frequent headaches who fulfilled the International Headache Society criteria for cervicogenic headache (excluding radiological criteria). These subjects were recruited from 450 headache sufferers who responded to newspaper advertisements.
  
  
  METHODS
  After randomization, 28 of the group received high-velocity, low-amplitude cervical manipulation twice a week for 3 wk. The remaining 25 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 a week for 3 wk.
  
  
  METHODS
  The change from week 1 to week 5 in analgesic use per day, in headache intensity per episode and in number of headache hours per day, as registered in a headache diary.
  
  
  RESULTS
  The use of analgesics decreased by 36% in the manipulation group, but was unchanged in the soft-tissue group; this difference was statistically significant (p = .04, chi 2 for trend). The number of headache hours per day decreased by 69% in the manipulation group, compared with 37% in the soft-tissue group; this was significant at p = .03 (Mann-Whitney). Finally, headache intensity per episode decreased by 36% in the manipulation group, compared with 17% in the soft-tissue group; this was significant at p = .04 (Mann-Whitney).
  
  
  CONCLUSIONS
  Spinal manipulation has a significant positive effect in cases of cervicogenic headache.
authors.affiliation: Institute of Medical Biology (Biomechanics), Faculty of Health Science, University of Odense, Denmark.
authors.forename: N
authors.initials: N
authors.lastname: Nilsson
authors.forename: H W
authors.initials: HW
authors.lastname: Christensen
authors.forename: J
authors.initials: J
authors.lastname: Hartvigsen
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D002574:Cervical Vertebrae; D002684:Chiropractic; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D053685:Laser Therapy; D008297:Male; D008405:Massage; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000700:Analgesics