Cervical Headaches?Manipulation or Muscular Retraining?
Reference:Jull G, Trott P, Potter H et al 2002 A randomized controlled trial of exercise and manipulative therapy fro cervicogenic headache. Spine 27(17):1835-43
Here is an excellent randomized controlled trial on the effectiveness of Physical Therapy on patients with cervicogenic headaches. (Another great Australian study!!)
200 patients with cervicogenic headaches were randomly allocated into four (4) groups.
1)Manipulative / mobilization therapy group (6 wks)
2)Muscular retraining group (6 wks)
3)Combined group (Manip, mobs & Exercises) (6 wks)
4)Control group (no treatments)
Result:At the 3-month, 6-month and one-year follow-up, the patients in groups 1,2 and 3 had significantly reduced headache frequency and intensity than group 4.
10% more patients had relief following the combination therapy versus either group 1 or 2.
Study Conclusion: Six weeks of muscular retraining and/or spinal mobilizations/manipulations can dramatically reduce symptoms of cervicogenic headaches. Six weeks of muscular retraining and/or spinal mobilizations/manipulations can dramatically reduce symptoms of cervicogenic headaches.
The great thing is that the effects are maintained 3,6 and 12 months later.
Clinical Relevance: This is a great study that supports the benefits of BOTH joint mobilizations and muscular retraining in patients presenting with cervicogenic headaches.
Personal Comment:If muscular retraining is as clinically effective as manipulations, perhaps upper cervical manipulations should be left as a last resort, considering their unlikely but potential harmful risks.
Posted on: April 03, 2003