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RESEARCH: TREATMENT OF HEADACHES

Wight JS. Migraine: a statistical analysis of chiropractic treatment. ACA J Chiro 1978;15:28-32

A analysis of the outcomes of chiropractic treatments of recurring headaches.

Conclusions: 74.6% of patients with recurring headaches, including migraines, were either cured or experienced reduced headache symptomatology after receiving chiropractic manipulation.

A proposed etiology of cervicogenic headache: the neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle. Alix ME, Bates DK. J Manipulative Physiol Ther. 1999 Oct;22(8):534-9

Findings: Connective tissue bridges were noted at the atlanto-occipital junction between the rectus capitis posterior minor muscle and the dorsal spinal dura. Also noted was that the ligamentum nuchae is continuous with the posterior cervical spinal dura and the lateral portion of the occipital bone. Anatomic structures innervated by cervical nerves C1-C3 and spinal cord and dura have the potential to cause headache pain.

Conclusions: Sizable bodies of clinical studies note the effect of manipulation on headaches - the 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.”

Dr. Jack’s Note: Subluxation causes increased tensions and inflammation across these connections and onto the spinal cord. It also causes myospasms that further increases these tensions.

Radiographic findings of the cervical spine in tension-type headache. Nagasawa A., Sakakibara T., Headache 1993; 33: 90-95

This study compared cervical spine radiographic findings of patients with headaches to a non-headache sufferers.

Findings: It was found that the cervical spinal curvature index was less in headache patients than in the controls. Many of the subjects with headaches had straight cervical curves.

Conclusions: Straighten cervical spine may result from subluxation causing excessive contraction of the cervical musculature. Subluxation could be a predisposing factor in headache pain.

Cervicogenic dysfunction in muscle contraction headache and migraine: A descriptive study. Vernon H., Steiman I., Hagino C., J Manip Physiol Ther, 1992; 15: 418-429

This study examined the prevalence of fixations, tender points, and amount of lordosis in the cervical spines of patients with cervicogenic headaches.

 

Findings: Approximately 90% of the subjects had hypomobile segments and multiple tender points in the cervical spine. 70% of the subjects had substantial alterations of cervical lordosis.

Conclusions: This study suggested the presence of cervical subluxation in headache patients; “… cervical spinal cord encroachment, as seen on MRI or CT, should not be considered an absolute contraindication to chiropractic cervical spine manipulation, provided the manipulation is applied by an appropriately trained and experienced practitioner, and is performed with the utmost care and skill.”; "Not only was manipulation not harmful in this patient population, but clinical improvement was seen.”

Efficacy of spinal manipulation for chronic headache: a systematic review. Bronfort G, Assendelft WJ, Evans R, Haas M, Bouter L. J Manipulative Physiol Ther. 2001 Sep;24(7):457-66

Conclusions: “Spinal manipulation therapy appears to have a better effect than massage for cervicogenic headache.”… “It also appears that spinal manipulation therapy has an effect comparable to commonly used first-line prophylactic prescription medications for tension-type headaches and migraine headaches.”

The effect of spinal manipulation in the treatment of cervicogenic headache. Nilsson N, Christensen HW, Hartvigsen J. J Manipulative Physiol Ther. 1997 Jun; 20(5):326-30

Findings: Analgesics use 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. Headache intensity per episode decreased by 36% in the manipulation group, compared with 17% in the soft-tissue group.

Conclusions: “Spinal manipulation has a significant positive effect in cases of cervicogenic headache.”

The efficacy of spinal manipulation, amitriptyline and the combination of both therapies for the prophylaxis of migraine headache. Nelson CF, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson AV. J Manipulative Physiol Ther. 1998 Oct;21(8):511-9

Conclusions: “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.”