Mobilization vs. Massage for Cervicogenic Headache

Spinal mobilization is more effective than massage therapy for relieving cervicogenic headache pain, according to a new study.

Cervicogenic headaches originate with a dysfunction in the cervical spine, or the neck region. Patients experience throbbing headaches at the base of the skull, with pain emanating down their neck and upper back, and sometimes above the eyes. Since symptoms often mimic migraine headache, cervicogenic headache can be difficult to diagnose. However, identifying and treating any spinal dysfunction related to headache often leads to significant relief in many patients. Chiropractors have long used a number of treatments for relieving cervicogenic headache, including spinal adjustments, spinal mobilization, trigger point therapy, exercise rehabilitation, and massage. These treatments have proven to be successful in a number of medical studies.

Researchers from the University of Dammam were interested in comparing the effectiveness of different manual therapies for cervicogenic headache (CGH). They studied a group of 36 patients with chronic CGH who were assigned to receive either massage or spinal mobilization. Massage therapy was applied to the neck region while mobilization was used on the upper cervical spine. Both groups practiced neck exercises for active range of motion, strength, and endurance.

After six weeks, both treatment groups had significantly reduced neck disability and improved range of motion. All patients also experienced a drop in headache pain intensity and frequency of headache attacks. However the mobilization group had the best results in decreased pain and headache frequency. There were no major differences between the groups in terms of functional disability scores.

These findings demonstrate the effectiveness of both massage and mobilization for CGH, but suggest that mobilization may offer enhanced treatment results.


Youssef EF and Shanb AS. Mobilization versus massage therapy in the treatment of cervicogenic headache: a clinical study. Journal of Back and Musculoskeletal Rehabilitation 2013; 26(1):17-24. doi: 10.3233/BMR-2012-0344.