Tension Headache
Tension Headache
Modern life is stressful, and tension headaches are one result of that stress. People with such headaches often describe a sensation like a tight band around the head; this band may in fact exist as a contracted muscle. Other characteristics of tension headache include aching, dull, or throbbing pain, usually concentrated in the forehead, temples, or base of the skull. Symptoms may overlap those of migraine, cluster, or sinus headaches, and medical advice may be necessary to distinguish between them.
Medical treatment for tension headaches generally involves the use of nonsteroidal anti-inflammatory drugs and possibly muscle relaxants. Physicians may also recommend physical therapy techniques in hopes of addressing the causes of tension headaches, such as muscle tension in the neck or jaw.
Chiropractic Spinal Manipulation
Neck tension can cause tension and pain in the head. Such “cervicogenic headaches” overlap closely with tension headaches. Chiropractic spinal manipulation has shown some promise for these conditions, but the evidence is incomplete and somewhat contradictory.
In a controlled trial of 150 participants, investigators compared spinal manipulation to the drug amitriptyline for the treatment of chronic tension-type headaches.8 By the end of the 6-week treatment period, participants in both groups had improved similarly. However, 4 weeks after treatment was stopped, people who had received spinal manipulation showed statistically significantly better reduction in headache intensity and frequency and used fewer over-the-counter medications than those who had used the amitriptyline.
In another positive trial, 53 participants with cervicogenic headaches received chiropractic spinal manipulation or laser acupuncture plus massage.9 Chiropractic manipulation was more effective.
However, a similar study of 75 participants with recurrent tension headaches found no difference between the two groups.10 Other, smaller studies of spinal manipulation have been reported as well, with mixed results.11
In a more recent controlled trial, 200 people with cervicogenic headaches were randomly assigned to receive one of four therapies: manipulation, a special exercise technique, exercise plus manipulation, or no therapy.12 Each participant received at least eight to 12 treatments over a period of 6 weeks. All three treatment approaches produced better results than no treatment, and approximately the same effect as each other. While these results may sound promising, in fact they prove nothing at all, since any treatment whatsoever will generally produce better results than no treatment due to the power of suggestion. . Ordinarily, researchers get around this problem by using double-blind, placebo-controlled trials (For more information on this important subject, see Why Does This Database Rely on Double-blind Studies?) While it isn’t possible to do a truly double-blind trial of chiropractic, the better trials noted previously used a form of placebo treatment, making them more reliable than this one.
For more information on this method, see the full chiropractic article.
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