One year after head trauma, 23 patients with post-traumatic headache entered a prospective clinically controlled trial to find out if specific manual therapy on the neck could reduce the headache. The study was completed by 19 patients (83%). Ten patients were treated twice with manual therapy and nine patients were treated twice with cold packs on the neck. The pain index was calculated blindly. Two weeks after the last treatment, the mean pain index was significantly reduced to 43% in the group treated with manual therapy (manipulation) compared with the pre treatment level. At follow-up five weeks later, the pain index was still lower in this group compared with the group treated with cold packs, but this difference was not statistically significant. The pain index for all 19 patients was significantly correlated to the use of analgesics as well as to the frequency of associated symptoms (number of days per week with dizziness, visual disturbances and ear symptoms). It is concluded that the type of manual therapy used in this study seems to have a specific effect in reducing post-traumatic headache. The result supports the hypothesis of a cervical mechanism causing post-traumatic headache and suggests that post-traumatic dizziness, visual disturbances and ear symptoms could be part of a cervical syndrome.

1. Cephalgia 1990; 10:241-250. From the County Hospital of Aarhus, Denmark.