Spinal Manipulation May Reduce Headaches

People suffering from chronic headaches caused by muscle spasms in the neck (cervicogenic headaches) may find relief by having their necks manipulated or by performing specific exercises to retrain neck muscles, according to a new study in Spine (2002;27:1835–43). This is the first study to rigorously evaluate the effectiveness of manipulation of the neck in treating cervicogenic headaches.

Cervicogenic headache arises from muscle spasms in the neck and is a common type of chronic and recurring headache. It also causes neck pain, which is aggravated by moving the neck in certain positions. This type of headache should not be confused with tension or migraine headaches, as the quality of the headaches and underlying causes are different. Cervicogenic headaches are most often due to poor posture. Conventional treatment includes analgesic medications such as acetaminophen (Tylenol®), aspirin, or ibuprofen (Advil®). In severe cases, muscle relaxants may be prescribed (Soma®, Flexeril®, Norflex®). This new study suggests cervicogenic headaches may be treated without the use of medications.

In this study, 200 people between the ages of 18 and 60 years were assigned to receive one of the following: (1) 8 to 12 treatments of manipulation therapy of the neck, (2) exercise therapy of the neck, (3) both therapies, or (4) no treatment at all for six weeks. Headache frequency, intensity, and duration, as well as neck pain and medication intake were recorded initially, at one week, and then 3, 6 and 12 months following treatment.

Those who received manipulation therapy, exercise therapy, or both, had a significant reduction in headache frequency, intensity, and duration when measured one week following treatment. The degree of improvement was similar in each of these groups, suggesting that combining therapies does not produce better results than using either treatment alone. More than 40% of the participants receiving treatment reported that their headaches had almost completely resolved. These beneficial effects were maintained 12 months after treatment had ended. Medication intake also decreased by more than 90% in each treatment group.

Although manipulation was as effective as exercise therapy, the latter may be preferable. The exercises can be done at home and have no known risks, whereas manipulation therapy requires a series of office visits to a qualified practitioner and has some risks associated with the treatment, including stroke. For more information, please consult a chiropractic, naturopathic, or osteopathic physician trained in manipulative therapies.

Darin Ingels, ND, MT (ASCP), received his bachelor’s degree from Purdue University and his Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. Dr. Ingels is the author of The Natural Pharmacist: Lowering Cholesterol (Prima, 1999) and Natural Treatments for High Cholesterol (Prima, 2000). He currently is in private practice at New England Family Health Associates located in Southport, CT, where he specializes in environmental medicine and allergies. Dr. Ingels is a regular contributor to Healthnotes and Healthnotes Newswire.

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