Chiropractic Research Results for Headache
Chiropractic Research Results for Headache
Compiled by Frank M. Painter, D.C.

Upper Crossed Syndrome and Its Relationship to Cervicogenic Headache
J Manipulative Physiol Ther 2004 (Jul); 27 (6): 414Û420
The principles of upper crossed syndrome and the use of exercise, chiropractic care, and myofascial release in the treatment of cervicogenic headache are discussed. A review of the literature indicates that analyzing muscle imbalance as well as vertebral subluxation may increase the effectiveness of chiropractic treatment for cervicogenic headache.

Chiropractic Spinal Manipulation for Cervicogenic Headache
in an 8-Year-Old
J Neuromusculoskeletal System 2002 (Fall); 10 (3): 98Ò103
A case of cervicogenic headache (CEH) in an 8-year-old boy that improved after chiropractic spinal manipulation is reported. An 8-year-old boy presented with a complaint of daily headache. The duration of symptoms was over 3 years. The patient met the diagnostic criteria for CEH. Awkward head position reproduced head pain, as did palpation of the upper cervical region. Decreased range of motion of the neck was evident, as well as abnormal tenderness and primarily of the right upper cervical region. A significant decrease in headache frequency as reported by the patient and parent was seen after the first treatment. After four treatments the headache frequency decreased to approximately one per month.

Efficacy of Spinal Manipulation for Chronic Headache:
A Systematic Review
J Manipulative Physiol Ther 2001 (Sep); 24 (7): 457Ò466
SMT appears to have a better effect than massage for cervicogenic headache. It also appears that SMT has an effect comparable to commonly used first-line prophylactic prescription medications for tension-type headache and migraine headache. This conclusion rests upon a few trials of adequate methodological quality. Before any firm conclusions can be drawn, further testing should be done in rigorously designed, executed, and analyzed trials with follow-up periods of sufficient length.

A Proposed Etiology of Cervicogenic Headache: The Neurophysiologic Basis and Anatomic Relationship Between the Dura Mater and the Rectus Posterior Capitis Minor Muscle
J Manipulative Physiol Ther 1999 (Oct); 22 (8): 534Ò539
A sizable body of clinical studies note the effect of manipulation on headache. These results support its effectiveness. The dura-muscular, dura-ligamentous connections in the upper cervical spine and occipital areas may provide anatomic and physiologic answers to the cause of the cervicogenic headache. This proposal would further explain manipulation's efficacy in the treatment of cervicogenic headache. Further studies in this area are warranted to better define the mechanisms of this anatomic relationship.

Chiropractic Management of Migraine Without Aura: A Case Study
Australasia Chiropractic and Osteopathic Journal 1999 (Nov): 8 (3)
It now appears clear that chiropractic care may be used to assist patients with migraine. Research is currently being undertaken to investigate the potential mechanisms of chiropractic in the treatment of migraine. This research should also assess what (if any) prognostic signs can be identified to assist practitioners making a more informed decision on the treatment of choice for migraine.

The Efficacy of Spinal Manipulation, Amitriptyline and the Combination of Both Therapies for the Prophylaxis of Migraine Headache
J Manipulative Physiol Ther 1998 (Oct); 21 (8): 511Ò519
There was no advantage to combining amitriptyline and spinal manipulation for the treatment of migraine headache. Spinal manipulation seemed to be as effective as a well-established and efficacious treatment (amitriptyline), and on the basis of a benign side effects profile, it should be considered a treatment option for patients with frequent migraine headaches.

Headache in Cervical Syndrome
Ther Umsch 1997 (Feb); 54 (2): 94Ò97
Headache is a common symptom in patients suffering from cervical spine disorders. The percentage of headaches in association with degenerative changes of the cervical spine ranges from 13 to 79% and that in association with indirect trauma of the cervical spine from 48 to 82%. Based on neuroanatomical and neurophysiological studies, the relationship of the upper cervical spine and the trigeminal nuclei has been demonstrated and serves as an explanation for perceived head pain in cervical spine disorders. As a source of pain, tension in the suboccipital muscles, irritation of the third occipital nerve, and degenerative changes of the C2/C3 joints have been discussed. Bogduk, in his studies, asserts a direct causative role of mechanical derangement of the cervical spine in the pathogenesis of cervicogenic headaches.

Clinical Study on Manipulative Treatment of Derangement of the Atlantoaxial Joint
J Tradit Chin Med 1999 (Dec); 19 (4): 273Ò278
The derangement of the atlantoaxial joint is one of main cervical sources of dizziness and headache, which were based on the observation on the anatomy of the upper cervical vertebrae, analysis of X-ray film of the atlantoaxial joint, and the manipulative treatment in 35 patients with cervical spondylosis.

The Effect of Spinal Manipulation in the Treatment
of Cervicogenic Headache
J Manipulative Physiol Ther 1997 (Jun); 20 (5): 326Ò330
The use of analgesics decreased by 36% in the manipulation group, but was unchanged in the soft-tissue group. The number of headache hours per day decreased by 69% in the manipulation group, compared with 37% in the soft-tissue group. Finally, headache intensity per episode decreased by 36% in the manipulation group, compared with 17% in the soft-tissue group. You might also enjoy this sidebar article Chiropractic Effective for Cervicogenic Headache.

Spinal Manipulation vs. Amitriptyline for the Treatment of Chronic Tension-type Headaches: A Randomized Clinical Trial
J Manipulative Physiol Ther 1995 ( Mar-Apr); 18 (3): 148Ò154
The results of this study show that spinal manipulative therapy is an effective treatment for tension headaches. Amitriptyline was slightly more effective in reducing pain by the end of the treatment period, but was associated with more side effects. Four weeks after cessation of treatment however, patients who received spinal manipulation experienced a sustained therapeutic benefit in all major outcomes in contrast to the amitriptyline group, who reverted to baseline values.

The Prevalence of Cervicogenic Headache in a Random Population Sample of 20-59 Year Olds
Spine 1995 (Sep 1); 20 (17): 1884Ò1888
A short questionnaire on headaches was mailed to 826 randomly selected residents of a midsized Danish town. A group of 57 individuals in the age range 20-59 years who reported having headache episodes on 5 or more days in the previous month were identified. Forty-five of the 57 were eventually interviewed and examined with respect to the IHS criteria for cervicogenic headache (the radiological criteria were omitted on ethical grounds). Of the 45 persons examined, eight fulfilled the diagnostic criteria for cervicogenic headache, equivalent to a prevalence in the headache group of 17.8%

The Effect of Manipulation (Toggle Recoil Technique) for Headaches With Upper Cervical Joint Dysfunction: A Pilot Study
J Manipulative Physiol Ther 1994 (Jul-Aug); 17 (6): 369Ò375
The results indicate statistically significant outcomes (p < .001) that indicate changes in headache frequency, duration and severity in all but two of the patients. The overall duration of headaches decreased from 110 hr pretreatment to 25 hr posttreatment, a decrease of 77%. The overall score for severity dropped from 55 to 22ÒÒ a 60% improvement in perceived pain. The frequency of headaches over a 2Òwk period dropped from 18 to 7, an improvement of 62%.

An Open Study Comparing Manual Therapy With the Use of Cold Packs in the Treatment of Post-traumatic Headache
Cephalalgia 1990 (Oct); 10(5): 241Ò250
It is concluded that the type of manual therapy used in this study seems to have a specific effect in reducing post-traumatic headache. The result supports the hypothesis of a cervical mechanism causing post-traumatic headache and suggests that post-traumatic dizziness, visual disturbances and ear symptoms could be part of a cervical syndrome.

Review More Abstracts on Chiropractic and Headache
Headaches are among the most common of health problems. Chiropractic and other non-medical practitioners are increasingly sought out by the public. Twenty-seven percent of Americans who visit health care providers outside of the medical field do so for headache relief, according to "Unconventional Medicine in the United States" N Engl J Med. 1993 (Jan 28); 328 (4): 246-252

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