A comparison of the initial and short term effects of cervical spine adjustments and acetylsalicylic acid in the treatment of mild to moderate episodic tension-type headache and its recurrence

Abstract

Episodic tension-type headache is more prevalent than chronic tension-type headache (Schwartz, et al. 1998). The exact causes of episodic tension-type headaches are not known (Headache Classification Committee, 1988:30-31). Episodic tension-type headache and chronic tension-type headache have different characteristics. Thus the mechanism of episodic tension-type headache is still unclear, and should be studied separately from chronic tension-type headache (Kim, et al. 1995). Presently, studies conflict with regard to spinal manipulation and its efficacy in the treatment of episodic tension-type headache. Therefore, the purpose of this study was to investigate the relative effectiveness of 500mg of acetylsalicylic acid as opposed to cervical spine manipulation for the treatment of episodic tension-type headache. It was hypothesized that manipulation would provide a significantly greater immediate and short-term benefit in comparison to acetylsalicylic acid. This study was conducted as a clinical trial at the Technikon Natal Chiropractic Day Clinic. Sixty patients presenting with episodic tension-type headaches were selected and randomly allocated into two equal groups. Patient's were provided with one of the two treatments at the initial consultation, and again upon a second consultation after a minimum 'washout period' of forty-eight hours, but within two weeks. Patient's in Group 1 received cervical spine manipulation, whereas patients in Group 2 received 500mg of acetylsalicylic acid. The subjective responses of each patient were recorded by means of the Short-form McGill Pain Questionnaire, the Numerical Pain Rating Scale, the CMCC Neck