Context: Episodic tension-type headache is common and is often treated using manual therapies. Few data exist for the efficacy of these interventions.
Objective: To determine the effects of spinal manipulation therapy on adults with episodic tension-type headache.
Design: Randomized controlled trial lasting 19 weeks.
Setting: Outpatient facility of a National Health Service-funded chiropractic research institution in Denmark.
Participants: Volunteer sample of 26 men and 49 women aged 20 to 59 years who met the diagnostic criteria for episodic tension-type headache as defined by the International Headache Society.
Intervention: Participants were randomized into 2 groups, 1 receiving soft tissue therapy and spinal manipulation (the manipulation group), and the other receiving soft tissue therapy and a placebo laser treatment (the control group). All participants received 8 treatments over 4 weeks; all treatments were performed by the same chiropractor.
Main outcome measures: Daily hours of headache, pain intensity per episode, and daily analgesic use, as recorded in diaries.
Results: Based on intent-to-treat analysis, no significant differences between the manipulation and control groups were observed in any of the 3 outcome measures. However, by week 7, each group experienced significant reductions in mean daily headache hours (manipulation group, reduction from 2.8 to 1.5 hours; control group, reduction from 3.4 to 1.9 hours) and mean number of analgesics per day (manipulation group, reduction from 0.66 to 0.38; control group, reduction from 0.82 to 0.59). These changes were maintained through the observation period. Headache pain intensity was unchanged for the duration of the trial.
Conclusion: As an isolated intervention, spinal manipulation does not seem to have a positive effect on episodic tension-type headache.