A recent study has suggested, however, that chiropractic treatments can decrease the frequency and length of headaches as well as the number of painkillers needed for relief. Dr. Niels Nilsson of Odense University in Odense, Denmark, and Dr. Geoffrey Bove of Beth Israel Deaconess Medical Center and Harvard Medical School, have studied the impact of chiropractic treatment on headaches. They have found that chiropractic treatment can work, but accurate diagnosis of the headache is key to efficacy. The diagnosis of tension headaches relies on very general symptoms.
Unfortunately, these symptoms can mask a headache of a different nature: cervicogenic headaches (originating in the cervical / neck region). Dr. Nilsson estimates that 15-20 percent of all recurrent headaches are cervicogenic.
Cervicogenic headaches are characterized by pain on one side of the head with associated neck pain on the same side. A patient with these headaches perceives pain in the head, but the actual source of the pain lies in the cervical spine.
This distinction is important, because cervicogenic headaches improve upon chiropractic spinal manipulation. Dr. Nilsson says, "My 1997 study showed that a group of cervicogenic headache patients who received spinal manipulation and soft tissue therapy did significantly better than a similar group which received only soft tissue therapy. Spinal manipulation in itself has a significant effect on cervicogenic headaches."
The most recent study indicates that, in contrast to cervicogenic headaches that respond specifically to spinal manipulation, tension headaches respond to chiropractic intervention regardless of whether or not spinal manipulation was performed. Dr. Bove says, "This study shows that tension-type headaches do respond to hands-on therapy, but that cervical spinal manipulation is unlikely to be the factor that affects change."
Dr. Norman Harden, director of the Center for Pain Studies at the Rehabilitation Institute of Chicago, believes the study was well designed. "All in all a very good study, considering the impossibility of blinding a chiropractic procedure. This study, a very vast amount of anecdotal and empiric evidence and now some legitimate studies such as this support the use of chiropractic treatment for tension-type headaches," he says. Most chiropractic patients have yet to realize the contribution chiropractic intervention can make to headache improvements. Only about two percent of patients visit a chiropractor for headache relief.
"Mary" is an example of the typical patient who turned to chiropractic treatment for her sore back. She was pleased to discover that the treatment could also eradicate her headaches. "I began to see a chiropractor for my back problems," she says. "During the treatment for back pain, I casually mentioned my almost daily "normal" tension headaches. My chiropractor advised me that a headache is not "normal". He recommended a few simple lifestyle changes and performed spinal manipulations. With the help of my chiropractor, I haven't had any notable headaches now for close to 10 years."