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Evidence-Based Medicine 2003; 8:109
© 2003 BMJ Publishing Group Ltd.

Therapeutics

Manipulative therapy and a low load exercise regimen each reduced the frequency and intensity of cervicogenic headache

Jull G, Trott P, Potter H, et al.A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache.Spine 2002;27:1835–43[CrossRef][Medline]

QUESTION: In patients with cervicogenic headache, does manipulative therapy and/or specific low load exercise reduce headaches?

Key Words: headache disorders • exercise • musculoskeletal manipulations

The first 150 words of the full text of this article appear below.

Design
Randomised (allocation concealed*), blinded (outcome assessors),* controlled trial with follow up immediately after treatment and at 12 months.

Setting
5 centres in Australia.

Patients
200 patients (mean age 37 y, 70% women) with cervicogenic headache, defined as unilateral (or unilateral dominant-side consistent) headache associated with neck pain and aggravated by neck postures or movement, joint tenderness in >=1 of the upper 3 cervical joints, and headache frequency of >=1 per week over a period of 2 months to 10 years. Exclusion criteria were bilateral headaches, features suggestive of migraine, contraindications to manipulative therapy, involvement in litigation or workers’ compensation, and physiotherapy or chiropractic treatment for headache in the previous 12 months. Follow up at 12 months was 97%.

Intervention
51 patients were allocated to manipulative therapy (MT), which included low velocity cervical joint mobilisation and high velocity manipulation. 52 patients were allocated to therapeutic exercise (ExT), which used low load endurance exercises . . . [Full text of this article]

Michael Yelland, MBBS, FRACGP

University of Queensland
Herston, Queensland, Australia




eLetters:

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This article is not about the real cervicogenic headache
Celio Levyman MD MSc
EBM Online, 30 Jun 2004 [Full text]

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