Chronic tension headache sufferers should consider chiropractic treatment as a long-term solution to their ailment without the side effects of drugs, according to a study funded by the Foundation for Chiropractic Education and Research (FCER). The study found that when six weeks of spinal manipulative  treatment by chiropractors was compared to six weeks of medical treatment with amitriptyline, and antidepressant used to control severe headache pain, the chiropractic patients experienced fewer side effects, and the positive effects of chiropractic proved to be longer term, with patients reporting continued relief after the study was completed.

       While anecdotal evidence has supported chiropractic treatment of tension headaches for years, until now, there have been no clinical trials that corroborate this reported success.  The study that brings scientific support to these claims, “Chiropractic Spinal Manipulative Therapy vs. Amitripyline for the Treatment of Chronic Tension-type Headaches: A Randomized Comparative Clinical Trial,” was conducted by Dr. Patrick D. Boline (principal investigator) at Northwestern College of Chiropractic and published in the March/April issue of the Journal of Manipulative and Physiological Therapeutics.

       For the study,  a total of 126 patients between the ages of 18 and 70 were divided into two groups that were screened and randomly assigned to receive either chiropractic spinal manipulation or pharmaceutical treatment consisting of amitriptyline, a tricyclic antidepressant commonly known by the brand name Elavil.  The spinal manipulation group received short-lever, low-amplitude, high-velocity thrust techniques with moist heat and light massage of the cervicothoracic musculature prior to manipulation.  Patients were palpated to determine the cervical, thoracic, or lumbar spinal segment to be manipulated with special attention to the upper three cervical segments.  The patients in the amitriptyline therapy group received 10 mg daily for the first week, 20 mg daily for the second week, and 30 mg daily thereafter.   This dosage was decreased if adverse side effected weren’t tolerated by the patient.

       During the six weeks that both groups received treatment, both reported similar improvements; however, four weeks after the end of the clinical trial, the superiority of chiropractic treatment was evident.  The group receiving spinal manipulation showed a reduction of 32 percent in headache intensity, 42 percent in headache frequency, 30 percent in over-the-counter medication usage, and a 16 percent improvement in functional health status.  The group receiving amitripytline reverted to the levels recorded at the beginning of the study.  The groups also differed greatly in their reporting of side effects.  While 82.1 percent of the patients who received medical treatment suffered from drowsiness, dry mouth and weight gain, only 4.3 percent of the spinal manipulation group reported side effects consisting of neck soreness and stiffness.

       “At last, with the results of this study, the claims of thousands of chiropractic patients who have enjoyed relief from pain will have to be taken seriously by the medical community,” said Stephen R. Seater, CAE, Executive Director of FCER. “At last, chiropractic will be recognized as a viable and scientific alternative for relief of common tension headaches.”