title: Spinal manipulations for the treatment of migraine: a systematic review of randomized clinical trials.
abstract: OBJECTIVE
  The objective of this systematic review was to assess the effectiveness of spinal manipulations as a treatment for migraine headaches.
  
  
  METHODS
  Seven databases were searched from inception to November 2010. All randomized clinical trials (RCTs) investigating spinal manipulations performed by any type of healthcare professional for treating migraine headaches in human subjects were considered. The selection of studies, data extraction and validation were performed independently by two reviewers.
  
  
  RESULTS
  Three RCTs met the inclusion criteria. Their methodological quality was mostly poor and ranged between 1 and 3 on the Jadad scale. Two RCTs suggested no effect of spinal manipulations in terms of Headache Index or migraine duration and disability compared with drug therapy, spinal manipulation plus drug therapy, or mobilization. One RCT showed significant improvements in migraine frequency, intensity, duration and disability associated with migraine compared with detuned interferential therapy. The most rigorous RCT demonstrated no effect of chiropractic spinal manipulation compared with mobilization or spinal manipulation by medical practitioner or physiotherapist on migraine duration or disability.
  
  
  CONCLUSIONS
  Current evidence does not support the use of spinal manipulations for the treatment for migraine headaches.
authors.affiliation: Complementary Medicine, Peninsula Medical School, University of Exeter, 25 Victoria Park Road, Exeter, UK. Paul.posadzki@pcmd.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Posadzki
authors.forename: E
authors.initials: E
authors.lastname: Ernst
mesh_terms: D006801:Humans; D020393:Manipulation, Spinal; D008881:Migraine Disorders / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome