Headache symptoms are very common, effecting approximately 16% of the population, and can be divided into three main categories: migraine, tension and cervicogenic headaches. Cervicogenic headaches are associated with neck pain and mechanical dysfunction of the cervical spine and therefore in theory should respond to spinal manipulation therapy (SMT) to restore normal neck movement.
A 2010 pilot study looked at patients with chronic cervicogenic headaches. The criteria included: at least 5 headaches a month for over 3 months; pain which started at the base of the skull and radiated over the top of the head to the front: and pain/reduced range of motion in the cervical spine. The patients were randomly assigned to 4 treatment groups for the 8 week study:
· High dose SMT (manipulation twice a week, totally 16 treatments)
· Low dose SMT (manipulation once a week, with the second session per week for information only, totally 8 treatments)
· High dose light massage (twice a week treatments, totally 16 treatments)
· Low dose light massage (weekly treatments with a second session per week for information only, totally 8 treatments)
The results of the study were:
- There was no difference in the high or low dose SMT groups, but SMT was more effective than light massage. At 8 weeks, the number of weekly headaches had decreased by 50% in the patients who received SMT.
- This difference was both statistically and clinically significant. Overall there was a decrease in intensity/pain of the cervicogenic headaches, decrease in headache frequency; and decrease in medication intake which was sustained with the SMT groups.
This study supports that SMT can work as an additional intervention with cervicogenic headaches, best in combination with soft tissue treatment, exercise and education.
Citation: The Spine Journal 2010; 10:117-128
No comments:
Post a Comment