Patients suffering from
cervicogenic headache (CeH) are commonly treated with spinal
manipulative therapy. We have analyzed the quality and the outcomes of published, randomized, controlled trials assessing the effectiveness of
spinal manipulation in CeH. Among 121 relevant articles, only two met all the inclusion criteria. Methodological quality scores were 8/10 and 7/10 points. Only one of the trials made use of a
headache diary. Both the trials reported positive (+) results on
headache intensity,
headache duration, and medication intake, so that spinal
manipulative therapy obtained strong evidence of effectiveness (level 1) with regard to these outcomes. Conversely,
spinal manipulation obtained no more than limited evidence (level 3) in reducing
headache frequency, as it was analyzed only in one study with positive (+) results. A greater number of well-designed, randomized, controlled trials are required to confirm or refute the effectiveness of
spinal manipulation in the management of CeH.