Cervicogenic Headache | Cervicogenic Headache Dose-Response

Cervicogenic Headache research study

What is the primary objective of this study?

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.

Who is eligible to participate?

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

Which medical condition, disease, disorder, syndrome, illness, or injury is researched?

Cervicogenic Headache

Study Interventions

Interventions can include giving participants drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available or noninvasive approaches such as surveys, education, and interviews.

Other:Spinal Manipulation5 minutes of high velocity, low amplitude thrust to cervical and upper thoracic spine.

Other:Light Massage5 minutes of light pressure massage to the neck and upper back

Study Arms

Research studies and clinical trials typically have two or more research arms. An arm is a group of people who receive the same treatment in the study.

High dose spinal manipulation18 visits for spinal manipulation

Moderate dose spinal manipulation12 visits for spinal manipulation and 6 visits for light massage

Low dose spinal manipulation6 visits for spinal manipulation and 12 visits for light massage

High dose massage18 visits for light massage

Study Status


Start Date: August 2012

Completed Date: August 2016

Phase: Phase 1/Phase 2

Type: Interventional


Primary Outcome: Headache days change from baseline for cervicogenic headache

Secondary Outcome: Average pain change from baseline for cervicogenic headache

Study sponsors, principal investigator, and references

Principal Investigator: Mitchell Haas, DC, MA

Lead Sponsor: University of Western States

Collaborator: National Center for Complementary and Integrative Health (NCCIH)

More information:

Hanson L, Haas M, Bronfort G, Vavrek D, Schulz C, Leininger B, Evans R, Takaki L, Neradilek M. Dose-response of spinal manipulation for cervicogenic headache: study protocol for a randomized controlled trial. Chiropr Man Therap. 2016 Jun 8;24:23. doi: 10.1186/s12998-016-0105-z. eCollection 2016.

Haas M, Bronfort G, Evans R, Schulz C, Vavrek D, Takaki L, Hanson L, Leininger B, Neradilek MB. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine J. 2018 Oct;18(10):1741-1754. doi: 10.1016/j.spinee.2018.02.019. Epub 2018 Feb 23.

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