FCER Comments on Study Revealing Deficit In Research on Manual Therapies for Tension-Type Headache

Norwalk, Iowa—The March 2006 issue of the Clinical Journal of Pain contains a systematic review of manual therapies research for the treatment of tension-type headache (TTH). After review of clinical and randomized controlled trials, published in English since 1994 and listed in MEDLINE, EMBASE, AMED, MANTIS, CINAHL, PEDro, and Cochrane databases, the researchers concluded that there is “no rigorous evidence that manual therapies have a positive effect in the evolution of TTH.” While these results are alarming, Anthony L. Rosner, Ph.D., LLD (Hon), Director of Research for the Foundation for Chiropractic Education and Research, admits that “regarding spinal manipulation, the most important aspect to carry away from this paper is that as a specific modality it may yet lack definitive supporting evidence in the management of tension-type headache.” The same is not true for cervicogenic headache (which this current study did not examine). For cervicogenic headache, there is high-quality evidence which suggests benefits specifically attributed to spinal manipulation. Dr. Rosner adds that “of all the healthcare providers able to distinguish between the types of headaches with an accurate diagnosis and then apply an appropriate therapy, it would appear that chiropractors more than any of the other alternatives are the best equipped to do so.” Even so, the chiropractic community must be aware that key areas of research are glaringly absent for the headaches and other conditions which they see on a regular basis. Such topics as the effects of the specific technique applied or its frequency and distribution over time are only now beginning to be addressed—and there is a long way to go. Outcome studies for pediatric headaches have yet to be published. The only way in which chiropractic is going to gain validation and reimbursement in these areas is through research, and it is through the support of FCER and its awarding of grants to deserving investigators within the chiropractic field that this goal can best be met. In the last 20 years alone, FCER—with the help of substantial financial input from NCMIC Insurance Company—has funded over $10 million in chiropractic research. Though every practicing D.C. has anecdotal, practice-based evidence supporting chiropractic efficacy for numerous conditions, that evidence will never be incorporated into systematic reviews. Quality published research is the only way that chiropractic will gain the respect it deserves in scientific circles. Please help chiropractic gain that respect today—join FCER. For more information on FCER, please go to www.fcer.org. FCER is a 501(c)(3) non-profit organization.