Cervicogenic headaches originate from disorders of the neck, including muscles, joints and ligaments innervated by the first three nerves coming from the spinal cord. Cervical headache is often caused by a sudden unguarded neck movement or sustained awkward head positioning. It is often accompanied by restricted range of motion in the neck, as well as vague neck, shoulder, or arm pain on the same side.

The most compelling study of chiropractic efficacy is Nelson’s randomized trial, comparing chiropractic to medical care, which included the drug amitriptyline, for the treatment of Migraine Headache. During the 4-week trial, both groups reduced in symptoms. After withdrawal of treatment, the medical group relapsed or got worse, whereas the group receiving chiropractic care maintained their improvements. The amitriptyline is more cost-effective as it is cheaper than the cost of visiting a doctor, but freedom from symptoms or a reduction in frequency only happened in the chiropractic group.

Independent (non-chiropractic) researchers reviewed research on many different types of behavioral and physical treatments for tension-type and cervicogenic headaches and found that cervical spinal manipulation was associated with improvement in cervicogenic headache outcomes (but not for tension-type headache), and was superior to soft-tissue therapies like massage.

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