Many headaches arise from cervical musculoskeletal disorders. Often, conservative therapies are recommended as the first treatment for cervicogenic headache, but it was previously unclear which treatments were the most effective. Should patients be prescribed a set of exercises and physical therapy sessions, chiropractic adjustments, or both? Will one lead to better outcomes?
A 2002 study sought to answer these questions by examining the effectiveness of a combination treatment involving both chiropractic adjustments and an exercise program. Two-hundred participants with chronic, moderate intensity cervicogenic headaches were assigned to one of four groups: spinal adjustments, exercise therapy, combined therapy, and a control group. Over six weeks of treatment, they reported their headache frequency, intensity, duration, pain, medication intake, and satisfaction with treatment. Researchers also measured physical outcomes such as pain on neck movement and a photographic measure of posture.
The study showed that all three active treatments (chiropractic adjustments, exercise, and a combination of both) were effective for improving the symptoms of cervicogenic headache, with benefits maintained at least 12 months following treatment. There was no statistical evidence of an additive effect when both chiropractic manipulation and exercise therapy were used simultaneously. Despite patients receiving combined treatments experienced the same clinical benefits as patients in the stand-alone treatment groups, a greater proportion of participants in the combined treatment group experienced good or excellent outcomes. This supports the use of combined treatments for the management of cervicogenic headaches.
Jull G, Trott P, Potter H, et al. A randomized controlled trail of exercise and manipulative therapy for cervicogenic headache. Spine 2002; 27(17):1835-1843.