Tension-type headache and cervicogenic headache are two of the most common non migraine headaches. Population-based studies suggest that a large proportion of adults experience mild and infrequent (once per month or less) tension-type headaches, and that the one-year prevalence of more frequent headaches (more than once per month) is 20%-30%; a smaller percentage of the population (roughly 3%) has been estimated to have chronic tension-type headachepopulation. This agrees with an earlier clinic-based study which found that 14% of headache patients treated had cervicogenic headache.
Physical treatments, like Chiropractic, is aimed at the prevention of headache episodes rather than the alleviation of symptoms once an attack has begun. If effective and available, these non-pharmacological treatments may be the first choice for most patients and may also be well suited for the significant minority of patients who: (a) have poor tolerance of pharmacological treatments; (b) have medical contraindications for pharmacological treatments; (c) experience insufficient relief from, or are unresponsive to, pharmacological treatment; (d) wish to become pregnant (or are nursing); (e) have a history of long-term, frequent, or excessive use of analgesic or abortive medications that can aggravate headache problems; or (f) simply prefer to avoid medication use.
The objective of this report is to describe and assess the evidence from randomized controlled trials (RCTs) and other prospective, comparative clinical trials (CCTs) for the efficacy and safety of behavioral and physical treatments for tension and cervicogenic headaches. Physical Treatments Results: Cervical spinal manipulation was associated with improvement in headache outcomes in two trials involving patients with neck pain and/or neck dysfunction and headache. Manipulation appeared to result in immediate improvement in headache severity when used to treat episodes of cervicogenic headache when compared with an attention-placebo control. Furthermore, when compared to soft-tissue therapies (massage), a course of manipulation treatments resulted in sustained improvement in headache frequency and severity. However, among patients without a neck pain/dysfunction component to their headache syndrome – that is, patients with episodic or chronic tension-type headache – the effectiveness of cervical spinal manipulation was less clear.
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