Study of Spinal Manipulative Therapy for Neck-Related Headaches Reports
Findings on Dose and Efficacy
Previous research suggests that spinal manipulative therapy (SMT) may be
helpful for various types of chronic headaches, including cervicogenic headache
(CGH), which is associated with neck pain and dysfunction. In a recent
randomized controlled trial, NCCAM-funded researchers from Western States
Chiropractic College and other institutions evaluated the dose (number of
treatments) and relative efficacy of SMT in a group of 80 patients with chronic
The study participants were assigned to an SMT group or a control group, which
received light massage. Participants in both groups received treatments from
chiropractors in 10-minute sessions either once or twice a week for 8 weeks, for
a total of 8 or 16 treatments. Participants who were treated only once a week
also had weekly examination visits, which included a discussion of the patient's
condition followed by a manual examination, as a control for provider
contact/attention. Researchers used pain and disability scales to evaluate the
participants' response to treatment once every 4 weeks for 24 weeks. They also
asked subjects about the number of headaches experienced.
Compared with massage, participants receiving SMT had greater improvements
in CGH-related pain and disability, lasting to 24 weeks. These differences were
clinically important and statistically significant. The dose effects of SMT
treatments (i.e., differences between 8 and 16 treatments) were small but
significant. The mean number of headaches reported by SMT subjects decreased
by more than half during the study.
The researchers concluded that their findings support SMT as a viable option for
treating CGH, but also point out that these findings should be considered
preliminary. They suggest additional research to determine whether SMT results
for patients with CGH are affected by treatment intensity and duration, use of
other therapies, lifestyle changes, and an integrative care approach.
* Haas M, Spegman A, Peterson D, et al. Dose response and efficacy of spinal
manipulation for chronic cervicogenic headache: a pilot randomized controlled
trial. Spine Journal. 2010;10(2):117–128.