Manual Therapy of Headaches of Spinal Origin:
An investigation of etiology, mechanisms, diagnosis and treatment

  • Howard Vernon

    Student thesis: Doctoral Thesis


    This thesis has proposed the following: "that mechanical disorders of the upper cervical spine are an important cause of headaches".

    Four hypotheses were developed to investigate this thesis.
    1. Upper cervical spine dysfunction plays an important role in headache etiology.
    2. The importance of this role is more or less, depending on the type of headache.
    3. Cervical dysfunction can be assessed and characterized by a range of standard clinical methodologies employed in manual therapy.
    4. The cervical dysfunction involved in these types of headaches is treatable by spinal manipulative therapy and this results in clinical benefit for patients with
    these conditions.

    Four areas of evidence from my published work have been summarized to support this thesis.

    A. An anaesthetized animal model of upper cervical deep somatic inflammation has provided pathophysiologic responses which could be the origins of headaches of cervical origin, particularly the type currently known as "cervicogenic headache".

    B. Clinical descriptions have been redefined to reveal common features which could be grouped together and attributed to pathologies or dysfunctions in the regions investigated in the animal model.

    C. A new form of questionnaire was developed which produced evidence of an association between headache and neck pathology or dysfunction.

    D. An extensive literature review revealed reported associations between headache and neck pathology in diverse works, particularly those involving manual assessment and therapeutic procedures in the cervical spine.

    The evidence from such diverse sources strongly supports the hypotheses developed here and my thesis, that mechanical disorders of the upper cervical spine are an important cause of headache.
    Date of Award2003
    Original languageEnglish
    SupervisorPeter McCarthy (Supervisor)

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