Spinal Manipulation for Headaches: Will Better Quality Trials Do the Trick?


  • Study funding: Dr. Wells was supported by an institutional National Research Service Award Number T32AT000051 from the National Center for Complementary & Alternative Medicine (NCCAM) at the National Institutes of Health. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Center for Complementary & Alternative Medicine or the National Institutes of Health.

  • Conflict of Interest: Dr. Wells reports no conflicts of interest.

R.E. Wells, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.


(Headache 2011;51:1149-1151)

Treatment for cervicogenic headache (CGH) can be challenging and is not always effective. Many patients turn to manipulative therapies, but what is the evidence this form of treatment works? Posadzki and Ernst performed a systematic review of trials of spinal manipulation for the treatment of CGH, which is published in this issue of Headache. The studies they located did not use clear or standard definitions for CGH or the manipulative interventions. The authors conclude that the evidence for spinal manipulative therapies for CGH is weak and more research is needed. This is particularly important because of rare but serious risks associated with this treatment option.