Osteopathic manipulative treatment and cervicogenic headache: a randomized controlled trial.
Stephan T Klemm, Walter Klemm, Regina Semmler-Ludwig et al.
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In 30 seconds
This randomized controlled trial evaluated osteopathic manipulative treatment (OMT) for cervicogenic headache in 413 patients allocated to findings-based OMT or standardized sham treatment. Participants received two treatments over 4 weeks, and the primary outcome was the Neck Disability Index (NDI). From baseline to final follow-up, NDI improved by 5.9 points (11.8 %) with OMT and 2.5 points (5.1 %) with placebo. Only the OMT group reached the established minimal clinically important difference of 5.5 points. The authors also reported greater benefit among patients with higher initial NDI scores.
Key findings
- NDI improved by 5.9 points (11.8 %) with OMT versus 2.5 points (5.1 %) with placebo.
- Only the OMT group reached the established NDI minimal clinically important difference of 5.5 points.
- OMT effect sizes were large: Cohen's d =0.74 short-term and 0.87 at follow-up.
- Patients with higher initial NDI scores benefited more from OMT than those with lower scores.
Why it matters
The trial suggests that OMT may improve pain-related functional disability in cervicogenic headache beyond a sham intervention, with the average NDI change reaching the stated clinically important threshold only in the OMT group. The reported greater benefit among patients with more severe initial disability may help frame expectations, although it does not establish which individuals will respond.
What to keep in mind
The abstract does not report the duration of follow-up or results for the secondary cervical-rotation outcome, limiting assessment of durability and that outcome.