Treating cervicogenic headache with spinal manipulation

Cervicogenic headaches originate in the upper spine, neck, and upper shoulders. It can a byproduct of whiplash, neck injury, or muscle trauma.

Prof, Ernst and a colleague reviewed the evidence.

First, the details.

  • 9 studies met the inclusion criteria.
  • Methodological quality was mostly poor.

And, the results.

  • The results from 8 studies suggested that spinal manipulation is more effective than physical therapy, gentle massage, drug therapy, or no intervention.
  • 3 studies showed no differences in pain, duration, and frequency of headaches compared to placebo, manipulation, physical therapy, massage, or wait list controls.
  • Adequate control for placebo effect was achieved in 1 study only, which showed no benefit of spinal manipulations beyond a placebo effect.
  • Most studies failed to provide details of adverse effects.

The bottom line?

There are few rigorous studies testing the effectiveness of spinal manipulations for treating cervicogenic headaches.

The authors concluded, “The results are mixed and the only trial accounting for placebo effects fails to be positive. Therefore, the therapeutic value of this approach remains uncertain.”

7/3/11 21:41 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.