Can spinal manipulation improves cervicogenic headache?

Introduction

Cervicogenic headache (CGH) is a type of headache that originates from the cervical spine or neck. Spinal manipulation therapy (SMT) is a common treatment for CGH, but its effectiveness and the optimal dose required for maximal relief are still under investigation. This synthesis aims to analyze the current research on whether spinal manipulation can improve cervicogenic headache.

Key Insights

Effectiveness of Spinal Manipulation:
- Spinal manipulation significantly reduces headache intensity, frequency, and medication use compared to soft-tissue treatments .
- SMT shows a better effect than massage for cervicogenic headache .
Dose-Response Relationship:
- A linear dose-response relationship exists, with more SMT sessions leading to a greater reduction in headache days. The highest dose (18 sessions) reduced headache days by half .
- Preliminary studies suggest that 9 to 12 treatments provide substantial pain relief compared to fewer sessions.
Comparison with Other Treatments:
- SMT combined with electrical dry needling is more effective than spinal mobilization and exercise in reducing headache intensity, frequency, and disability.
- SMT has similar short-term efficacy to amitriptyline for chronic tension-type and migraine headaches, but is more effective than massage for cervicogenic headache.
Methodological Considerations:
- Some studies indicate positive results but highlight methodological issues that prevent unequivocal conclusions .
- More well-designed, randomized controlled trials are needed to confirm the effectiveness of SMT for cervicogenic headache .

Conclusion

The current body of research suggests that spinal manipulation therapy is effective in reducing the intensity, frequency, and medication use associated with cervicogenic headache. A higher number of SMT sessions generally leads to better outcomes. However, further well-designed studies are necessary to solidify these findings and determine the optimal treatment dose.

Can spinal manipulation improves cervicogenic headache?

Summary

Consensus Meter

Introduction

Key Insights

Conclusion

Sources and full results

The effect of spinal manipulation in the treatment of cervicogenic headache.

Spinal manipulation significantly reduces analgesic use, headache hours, and headache intensity in cervicogenic headache patients.

A randomized controlled trial of the effect of spinal manipulation in the treatment of cervicogenic headache.

Spinal manipulation may have a possible effect on cervicogenic headache, but due to methodological problems, its effectiveness cannot be unequivocally demonstrated.

Dose–response of spinal manipulation for cervicogenic headache: study protocol for a randomized controlled trial

Spinal manipulation therapy shows potential in reducing headache frequency and improving quality of life in adults with cervicogenic headache.

Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial.

Spinal manipulative therapy (SMT) has a linear dose-response relationship, with the highest and most effective dose of 18 visits reducing cervicogenic headache days by half and 3 more days per month than light-massage control.

Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial.

Spinal manipulative therapy (SMT) shows clinically important differences in pain relief and reduced headache frequency compared to light massage for chronic cervicogenic headache patients.

Spinal manipulation and perineural electrical dry needling in patients with cervicogenic headache: a multi-center randomized clinical trial.

Spinal manipulation and electrical dry needling significantly reduce headache intensity, frequency, and disability compared to spinal mobilization and exercise at a 3-month follow-up.

Spinal Manipulative Therapy in the Management of Cervicogenic Headache

Spinal manipulative therapy shows strong evidence of effectiveness in reducing headache intensity, duration, and medication intake, but limited evidence in reducing headache frequency.

Efficacy of spinal manipulation for chronic headache: a systematic review.

Spinal manipulative therapy (SMT) shows moderate evidence of short-term efficacy similar to amitriptyline in treating chronic tension-type headache and migraine, with better results than massage for cervicogenic headache.

Manual therapies for cervicogenic headache: a systematic review

Physiotherapy and cervical spinal manipulative therapy may be effective treatments for cervicogenic headache, but more research is needed to confirm these findings.

Dose response for chiropractic care of chronic cervicogenic headache and associated neck pain: a randomized pilot study.

Larger doses, 9 to 12 treatments, of chiropractic care show a substantial benefit in pain relief for chronic cervicogenic headache patients compared to 3 visits per week.

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