The aim of the present study was to investigate the possible effects of chiropractic spinal manipulation and mobilization in subjects with chronic tension-type headache (CTTH). The study design was a randomized, comparative clinical trial, consisting of II patients, without placebo control. Eleven patients diagnosed with CTTH were selected following a case history and relevant physical/orthopaedic examination. The patients were randomly allocated to one of two groups: (I) manipulation (n = 5); and (2) mobilization (n = 6). The study included a 2-week baseline period, after which patients received up to eight treatments over a 4-week period. Subjective findings were recorded with the Headache Diary, the Numerical Pain Rating Scale 101 and the Neck Disability Index. Objective findings consisted of six cervical ranges of motion (RoMs) obtained by means of a digital inclinometer. Fifteen subjects responded to the recruitment advertisements. Four were excluded during the screening process. The frequency, duration and intensity of the headaches were not significantly reduced in both groups after the treatment period, although the descriptive statistics suggested that both treatments produced a favourable outcome. The effect size indices indicated that both treatments had clinical relevance, with group I (manipulation) perhaps demonstrating greater benefit. The cervical RoMs did not significantly change following treatment in either group. Both treatments appeared to reduce the activity of CTTHs based on the descriptive statistics and effect size, but the results were insufficient to obtain statistical significance. However, the authors feel that there is adequate evidence to support further studies using larger sample sizes.

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