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Cervicogenic Headache Dose-Response

Phase 1
Completed
Conditions
Cervicogenic Headache
Interventions
Other: Spinal Manipulation
Other: Light Massage
Registration Number
NCT01530321
Lead Sponsor
University of Western States
Brief Summary

This study will determine the number of visits to a chiropractor for spinal manipulation and light massage necessary for the optimal relief of cervicogenic headache (headache with associated neck pain). Effectiveness of care will also be determined.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
256
Inclusion Criteria
  • chronic cervicogenic headache
  • threshold pain level
  • threshold headache frequency
  • independently ambulatory
  • English literate
  • candidate for spinal manipulation
Exclusion Criteria
  • contraindication to thrust spinal manipulation or massage
  • most other headache types
  • Recent manual/exercise therapy from licensed provider for head/neck
  • threshold pain medication use
  • pregnancy
  • involvement with another pain study
  • suspicion of unmanaged depression
  • most cancers
  • hypertension (at least stage II)
  • complicating neurological/spinal conditions
  • pre-randomization noncompliance or cannot/will not comply with protocols
  • health-related litigation, claims, or disability compensation

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Low dose spinal manipulationLight Massage6 visits for spinal manipulation and 12 visits for light massage
High dose massageLight Massage18 visits for light massage
High dose spinal manipulationSpinal Manipulation18 visits for spinal manipulation
Moderate dose spinal manipulationLight Massage12 visits for spinal manipulation and 6 visits for light massage
Moderate dose spinal manipulationSpinal Manipulation12 visits for spinal manipulation and 6 visits for light massage
Low dose spinal manipulationSpinal Manipulation6 visits for spinal manipulation and 12 visits for light massage
Primary Outcome Measures
NameTimeMethod
Headache days change from baseline for cervicogenic headache0, 6, 12, 24, 39, 52 weeks

Days with cervicogenic headache in the last four weeks from a daily headache diary. Change score = follow-up score - baseline score)

Secondary Outcome Measures
NameTimeMethod
EuroQol-5D change from baseline0, 12, 24, 39, 52 weeks

Health-related quality of life

Outside Care change from baseline0, 6, 12, 24, 39, 52 weeks

Visits to providers outside the study for care of cervicogenic headache. Includes hospital and emergency room visits

Quality-adjusted life years change from baseline0, 12, 24, 39, 52 weeks

utility for cost-effectiveness analysis

Neck pain days change from baseline0, 6, 12, 24, 39, 52 weeks

Number of days with neck pain in last 4 weeks from recall.

Objective biomechanical measures change from baseline0, 6 weeks

Measures of cervical joint function and kinematics including global range of motion, spinal segmental joint restriction, pain pressure thresholds

Headache-related disability days change from baseline0, 6, 12, 24, 39, 52 weeks

Number of days in the last four weeks from recall unable to carry out daily work for at least one half day because of cervicogenic headache.

medication use change from baseline0, 6, 12, 24, 39, 52 weeks

Number days of use of prescription and nonprescription medications for headaches with neck pain

Perceived headache average pain change from baseline for cervicogenic headache0, 6, 12, 24, 39, 52 weeks

Perceived change in average pain from baseline on a -10 to +10 (21-point) numeric rating scale

Average pain change from baseline for cervicogenic headache0, 6, 12, 24, 39, 52 weeks

Average cervicogenic headache pain in the last four weeks evaluated by averaging daily headache diary pain scores. Pain is rated on a 0 to 11 numeric rating scale.

Headache-related disability change from baseline for cervicogenic headaches0, 6, 12, 24, 39, 52 weeks

Headache Impact Test (HIT-6)

Average pain change from baseline for neck0, 6, 12, 24, 39, 52 weeks

Average neck pain in the last four weeks from recall. Pain is rated on a 0 to 11 numeric rating scale.

Patient Satisfactionweek 12

Likert scale for success of care

Direct & Indirect costs change from baseline0, 6, 12, 24, 39, 52 weeks

Health services; lost work days and productivity

Perceived headache improvement from baseline for cervicogenic headache0, 6, 12, 24, 39, 52 weeks

Perceived cervicogenic headache improvement from baseline on a 9-point Likert-like scale.

Trial Locations

Locations (2)

Northwestern Health Sciences University

🇺🇸

Bloomington, Minnesota, United States

University of Western States

🇺🇸

Portland, Oregon, United States

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