Customize your JAMA Network experience by selecting one or more topics from the list below.
Bove G, Nilsson N. Spinal Manipulation in the Treatment of Episodic Tension-Type Headache: A Randomized Controlled Trial. JAMA. 1998;280(18):1576–1579. doi:10.1001/jama.280.18.1576
From the Center for Biomechanics, Department of Anatomy and Cell Biology, Odense University, Odense, Denmark. Dr Bove is now with the Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass.
Context.— Episodic tension-type headache is common and is often treated using
manual therapies. Few data exist for the efficacy of these interventions.
Objective.— To determine the effects of spinal manipulation therapy on adults with
episodic tension-type headache.
Design.— Randomized controlled trial lasting 19 weeks.
Setting.— Outpatient facility of a National Health Service–funded chiropractic
research institution in Denmark.
Participants.— Volunteer sample of 26 men and 49 women aged 20 to 59 years who met
the diagnostic criteria for episodic tension-type headache as defined by the
International Headache Society.
Intervention.— Participants were randomized into 2 groups, 1 receiving soft tissue
therapy and spinal manipulation (the manipulation group), and the other receiving
soft tissue therapy and a placebo laser treatment (the control group). All
participants received 8 treatments over 4 weeks; all treatments were performed
by the same chiropractor.
Main Outcome Measures.— Daily hours of headache, pain intensity per episode, and daily analgesic
use, as recorded in diaries.
Results.— Based on intent-to-treat analysis, no significant differences between
the manipulation and control groups were observed in any of the 3 outcome
measures. However, by week 7, each group experienced significant reductions
in mean daily headache hours (manipulation group, reduction from 2.8 to 1.5
hours; control group, reduction from 3.4 to 1.9 hours) and mean number of
analgesics per day (manipulation group, reduction from 0.66 to 0.38; control
group, reduction from 0.82 to 0.59). These changes were maintained through
the observation period. Headache pain intensity was unchanged for the duration
of the trial.
Conclusion.— As an isolated intervention, spinal manipulation does not seem to have
a positive effect on episodic tension-type headache.
Create a personal account or sign in to: