CRD summary

This review concluded that spinal manipulative therapy might be effective in reducing headache intensity, headache duration, medication intake and, to a lesser extent, the frequency of headaches. This conclusion was based on a flawed synthesis of two studies and so may not be reliable.

Authors' objectives

To assess the effectiveness of spinal manipulative therapy in cervicogenic headache.

Searching

MEDLINE, EMBASE, AMED, MANTIS, CINAHL and the Cochrane Library were searched (dates not reported); the search terms were given. The search was not restricted by language of publication.

Study selection

Assessment of study quality

The methodological quality of the included trials was assessed according to published criteria (the PEDro scale).

Data extraction

Two reviewers independently extracted the data. Data on key study characteristics and results were extracted.

Methods of synthesis

Results of the review

Two RCTs (n=253) were included in the review.

One RCT scored 8 out of 10 points on the PEDro quality assessment scale, while the second scored 7 out of 10.

Both RCTs reported positive findings for spinal manipulation in terms of headache intensity and duration and medication intake. One RCT also reported a positive finding for headache frequency.

Authors' conclusions

Spinal manipulative therapy might be effective in reducing headache intensity, headache duration, medication intake and headache frequency.

CRD commentary

The review question was supported by an appropriate set of inclusion criteria. The search for relevant literature covered several electronic databases and was not restricted by language. However, no other sources appeared to have been searched and the search dates were not reported. Therefore, potentially relevant studies might have been missed. Attempts were made to assess the validity of the included studies and to minimise error and bias in the data extraction by using two independent reviewers. However, no such procedures were reported for the selection and quality assessment of the research literature. The synthesis of the included studies was based on a very basic 'vote count' for each outcome, which does not take into account how the outcome was measured or the size or clinical relevance of any potential effect. On this basis, the authors' conclusion that spinal manipulative therapy might be effective for cervicogenic headache appear overly positive.

Implications of the review for practice and research

Practice: The authors did not state any implications for practice.

Research: The authors stated that a greater number of well-designed RCTs are required to confirm or refute the effectiveness of spinal manipulation in the management of cervicogenic headache.

Bibliographic details

Fernandez-de-las-Penas C, Alonso-Blanco C, Cuadrado M L, Pareja J A. Spinal manipulative therapy in the management of cervicogenic headache. Headache 2005; 45(9): 1260-1263. [PubMed: 16178960]

Indexing Status

Subject indexing assigned by NLM

MeSH

Female; Humans; Male; Manipulation, Chiropractic; Post-Traumatic Headache /therapy; Randomized Controlled Trials as Topic; Treatment Outcome

AccessionNumber

12006005040

Database entry date

31/07/2007

Record Status

This is a critical abstract of a systematic review that meets the criteria for inclusion on DARE. Each critical abstract contains a brief summary of the review methods, results and conclusions followed by a detailed critical assessment on the reliability of the review and the conclusions drawn.