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July 21, 1999

Spinal Manipulation for Tension-type Headache

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;282(3):231-233. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-3-jac90006

To the Editor: The conclusion drawn by Drs Bove and Nilsson1 did not seem to accurately reflect the results of their study. Spinal manipulation was not assessed "as an isolated intervention," but was tested in combination with deep friction massage. The conclusion regarding its efficacy for ETTHs is therefore incorrect and misleading. This study also regards spinal manipulation as a whole to reflect the 2 techniques that were administered in this study. There are thousands of spinal manipulative techniques. Only 2 were used in this study (toggle recoil and diversified). To imply that these techniques are reflective of spinal manipulation as a whole, as the authors did, would be akin to generalizing the efficacy for all analgesics based on a limited study involving aspirin.

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