Migraine subjects from a randomized controlled trial of spinal manipulation for the treatment of cervicogenic headache

Background: Some patients who present with chronic cervicogenic headaches have also been diagnosed with migraine headaches.

Purpose: Secondary analysis, from data generated by a randomized clinical trial, to compare efficacy of SMT versus LM for 22 CHG subjects with concomitant migraine headache.

Methods: Eighty participants were randomized to receive SMT or LM for 8 or 16 treatment sessions. 22 of these patients were previously diagnosed with migraine headaches. Patients were treated once or twice per week for 8 weeks. Outcomes included a modified Von Korff (MVK) 100-point pain scale and number of headaches in the last four weeks. Data were collected every four weeks for 24 weeks. Comparisons were made using regression modeling for individual time points with baseline characteristics as covariates and imputed missing data.

Results: Among migraine subjects, for the headache pain scale, there was a clinically important advantage for SMT over the control: -15.0 95%CI (-35.2, -5.2) at 12 weeks and -19.7 95%CI (-39.6, 0.1) at 24 weeks. The number of headaches also improved in SMT over the control: -4.3 95%CI (-12.8, 4.1) at 12 weeks and -3.7 95%CI (-11.8, 4.3) at 24 weeks.

Conclusion: Clinically important differences in relief of headache pain for subjects with chronic CGH and a previous diagnosis of migraine were observed between SMT and a control intervention favoring SMT.