• Mootz RD
• Cook RD
• Schorr DB

• Cervical Vertebrae
• Headache
• Manipulation, Spinal
• Muscle Contraction
• Open Access Document

Objective: To assess effectiveness of chiropractic management, primarily cervical adjustment, in the treatment of chronic episodic muscle tension type headache in male patients.

Design: Prospective case series analysis with pre-treatment baseline. Sixteen sessions of chiropractic care were provided to each patient over an eight week period. Data was also collected during a two week no-treatment baseline period prior to initiation of care. The subjects took no pain medication or had any other treatment for the entire duration of the study.

Setting: A large chiropractic teaching clinic: Palmer College of Chiropractic-West Outpatient Clinic.

Participants: Eleven male outpatients between the ages of 18-40 years old with a self-reported history of chronic headache at least six months duration and an average of at least weekly headache episodes were recruited. There was one dropout due to moving out of the area before study completion.

Interventions: Primary: high velocity, short lever cervical adjustment (Diversified technique). Secondary: myofascial trigger point therapy using ischemic compression to the cervical and thoracic musculature; thoracic and lumbar adjustment if indicated (Diversified technique); moist hot packs to cervical and thoracic spine regions.

Outcome measures: Pain diary measuring frequency, duration, and intensity of head/neck pain; and McGill Pain Questionnaires.

Results: Mean pre-treatment to post-treatment headache frequency changed from 6.4 episodes per two week period to 3.1, a statistically significant change (p < 0.01). Mean pre-treatment to post-treatment headache duration changed from 6.7 hours per episode to 3.88 hours which was statistically significant (p < 0.05). Mean anchored pain scale intensity ratings changed from 5.05 to 3.37 but this was just beyond statistical significance (p = 0.059). There were no significant changes in any McGill pain questionnaire scores pre and post treatment.

Conclusions: In this case series analysis of episodic tension headache in 10 male patients, typical chiropractic interventions of adjusting, muscle work and moist heat significantly reduced self-reported frequency and duration of headache episodes following 12 treatments over an 8 week period. No significant effect was observed in self-reported pain intensity, however a trend of reduction may indicate that a larger sample size might show increased significance. The McGill Pain Questionnaire did not appear to provide any useful information in assessing change in this sample. This may lend support to the result that little or no effect is obtained in reducing intensity of individual headache episodes with this treatment approach. These findings are limited by the small sample size and suggest a need for a larger study population as well as specific treatment comparison studies. These results may further be limited in that all subjects were male.

This abstract is reproduced with the permission of the publisher. Click on the above link for free full text.