Spinal Manipulation and Episodic Tension-type Headache

Episodic tension-type headaches (TTHs) are extremely common, affecting more than one-third of the population and accounting for more than two-thirds of all headache episodes.

This randomized controlled trial attempted to discover if spinal manipulation therapy has a positive effect on adults suffering from the episodic form of TTH. The results of this study were that spinal manipulation did not significantly improve the outcome of episodic tension-type headache. Although this appears to be negative outcome for doctors of chiropractic who regularly and successfully treat patients for headaches, the authors point to factors that have positive implications for chiropractors and their patients.

Because ETTH may be less responsive to spinal manipulation than is cervicogenic headache, the message for chiropractors is that accurate diagnosis in the selection of patients for spinal manipulation is critically important.

Take note: The researchers who conducted this study comment that in practice ETTH and cervicogenic headache can be difficult to differentiate, and often occur together. Further, they state: "Our conclusions are in stark contrast to those of an earlier and very similar study [Nilsson, et al. Journal of Manipulative and Physiological Therapeutics, 1997;20, pp326-30] of cervicogenic headache, in which the effect of spinal manipulation was quite dramatic."

Bove G, Nilsson N. Spinal manipulation in the treatment of episodic tension-type headache: A randomized controlled trial. Journal of the American Medical Association, Nov. 11, 1998;280(18), pp1576-79.