Headache

Spinal manipulation vs. Amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. Boline PD, Kasaak K, Bronfort G, Nelson C, Anderson AV.JPT, 1995; 18:148-154.
Six weeks of drug therapy were compared to six weeks of chiropractic adjustments. The drug therapy was considered slightly more effective than chiropractic however 82% of the patients had side effects which included drowsiness, weight gain and dry mouth. Cardiac problems and glaucoma were also associated with amitriptyline use.
Chiropractic patients had no side effects (apart from slight neck stiffness in the first two weeks of the study that 5% of the patients reported).
After four weeks chiropractic and drug therapy was halted in both groups. The patients who used drugs began having headaches again while the chiropractic group continued to express headache relief, also higher levels of energy and vitality than the drug therapy group.

The effect of manipulation (toggle recoil technique) for headaches with upper cervical joint dysfunction: a pilot study. Whittingham, W, Ellis WB, and Molyneux TP, JMPT, July/August 1994, 17(6): 369-375.
Twenty-six patients (16males, 10 females) all had chronic headaches with upper cervical joint dysfunction. Significant diminishing of the severity and frequency of headaches was reported in a large majority of the subjects (24 out of 26).

Chiropractic care of a 13-year-old with a headache and neck pain: a case report. Hewitt EG. Journal of the Canadian Chiropractic Association, Sept. 1994; 38(3): 160-162.
From the abstract: "This report describes a 13 year old female who had suffered from severe headache and neck pain for five days. Following a series of four chiropractic treatments over a two-week period, her headache and neck pain resolved."
Patient had injured her neck in gymnastics. Her neck pains and shortly after her headaches resolved. At a four weeks follow-up she remained pain free.

Chiropractic care of children with headaches: five case reports. Anderson-Peacock, ED, Journal of Clinical Chiropractic Pediatrics, Vol. 1, No. 1, Jan. 1996.
From the abstract: In this case series, five children presented with varying types of headaches to a family-based chiropractic practice. In each case, spinal subluxations were present. Following reduction of those subluxations through chiropractic adjustment the child's chief complaint remised. Adjunctive therapy (education of diet, posture and exercise) was not given until the headaches remised. Thus it was felt that the headache reduction might have been due to the restoration of nervous system function through the chiropractic adjustment. Chiropractic management of headaches should be further researched in children.

A holistic approach to severe headache symptoms in a patient unresponsive to regional manual therapy. Stude, DE and Sweere, JJ. JMPT 1996; 19:202-7.
This case history deals with a woman who suffered severe migraine headache symptoms who found no relief from medical care or cervical chiropractic adjustments.
From the Abstract:
Objective: To discuss the case of a patient suffering from severe headache complaints who was previously unresponsive to regional cervical spine care.
Intervention and Outcomes: Manual chiropractic spinal adjustments were provided as the only treatment intervention. After a course of treatment, the patient reported no visits to the emergency room, even after a 1-year follow up, and the average visual analogue pain decreased.
Conclusion: This patient seemed to respond favorable to conservative care that included regions of the spine not traditionally associated with headache pain.

Chiropractic Treatment of Chronic Episodic Tension type headache in Male Subjects: A Scase Series Analysis. Mootz RD, Dhami MSI, Hess JA, et al. Journal of the Canadian Chiropractic Association, 1994; 38(3): 152-159.
Ten male outpatients 18-40 years old with a history of chronic headache of at least six months in duration occurring at least once a week were seen in the Palmer College of Chiropractic-West Outpatient clinic. Diversified technique was the primary care. Results showed an over 50% decrease in headache frequency and duration. Mean anchored pain scale intesity ratings changed from 5.05 to 3.37 which was "just beyond statistical significance... there was no significant chnges in any McGill Pin Questionaire scores pre and post treatment. A large sampling size is suggested for a larger study.

Chiropractic Management of Migraine Without Aura: A Case Study. Lenhart, L.J. JNMS 1995:3(10): 20-26.
A case of migraine is discussed. The author has done a number of tests to objectify his care. The patient continued his improvement two months post-spinal (cervical) adjustments.

Diagnosis and treatment of TMJ, head, neck and asthmatic symptoms in children. Gillespie BR, Barnes JF, J of Craniomandibular Practice, Oct. 1990, Vol 8, No. 4.
From the abstract: "Pathologic strain patterns in the soft tissues can be a primary cause of headaches, neckaches, throat infections, ear infections, sinus congestion, and asthma."

Chiropractic adjustment in the management of visceral conditions: a critical appraisal. Jamison JR, McEwen AP, Thomas SJ. JMPT, 1992; 15:171-180.
This was a survey of chiropractors in Australia. More than 50% of the chiropractors stated that asthma responds to chiropractic adjustments; more than 25% felt that chiropractic adjustments could benefit patients with dysmenorrhea, indigestion, constipation, migraine and sinusitis.

Chiropractic treatment of chronic episodic tension type headache in make subjects: A case series analysis. Mootz, RD, Dhami MSI, Hess JA, et al. Journal of the Canadian Chiropractic Association, September 1994; 38(3): 152-159.
This study was conducted at the Palmer College of Chiropractic- West Outpatient Clinic. It involved 11 men between the ages of 18 and 40 who suffer from headache. The patients reported consistent and significant reduction in the frequency and duration of headaches. However the intensity of the headaches in this group was unchanged. The adjustments used were diversified with myofascial trigger point therapy, and moist hot packs.
This study reflects a serious limitation of studies found in nearly all research on the effects of spinal care. There is no inter-technique study. Would another adjusting technique be more effective? Less effective? Unfortunately that research was not done.