Our approach is guided by:
1️⃣ Bryans et al., 2011 – Journal of Manipulative & Physiological Therapeutics
Systematic review of 21 clinical trials.
Findings:
✔ Spinal manipulation is recommended for cervicogenic headache
✔ Spinal manipulation and multimodal care are recommended for migraine
⚖ Evidence for spinal manipulation alone in tension-type headache remains equivocal
✔ Low-load craniocervical mobilisation may help tension headaches
Strength of evidence: Moderate
2️⃣ Fernández-de-las-Peñas et al., 2006 – Journal of Orthopaedic & Sports Physical Therapy
This review examined the methodological quality of RCTs.
It found:
- Only 8 qualifying studies
- Many had small sample sizes.
- Blinding was difficult
- Placebo controls were limited.
Conclusion:
Higher-quality trials are needed.
This is important. - It means manual therapy research is challenging — not that it is ineffective.
It's in the detailed consultations that we can diagnose whether there are cervicogenic elements to your migraines or tension headaches, or indeed whether your headache type diagnosis was just to legitimise pain or neuro meds.
We believe patients deserve transparency about this, and if you want to be free of your headaches or be happy with a massive reduction, then the investment in a consultation at the clinic is worth it.