Nice Clinical Guideline 150 – Headaches

The BCA welcomes the publication today of Clinical guideline 150 “Headaches – Diagnosis and management of headaches in young people and adults” and was pleased, as a Stakeholder, in conjunction with the Anglo European College of Chiropractic to have input to the Guideline Development Group.

 

Whilst there is no specific recommendation for manual therapy for the management of primary headaches, in several studies, the clinical trials suggest that manual therapy is at least as good as conventional care for headaches. More recent trials, not yet considered by NICE, show more favourable outcomes (1) (2).

 

Medication overuse has been associated with harm. The BCA suggests that manual therapy is a low risk intervention that may offer relief to those who do not wish to take medication

 

The BCA supports the need for further research into this often debilitating condition. This should include the class of cervicogenic headaches responsible for one in six cases of headache caused by neck problems which has not been included in this NICE guideline.

 

References:

  1. Effectiveness of manual therapy for chronic tension-type headache: a pragmatic, randomised, clinical trial. Castien RF, van der Windt DA, Grooten A, Dekker J. Cephalalgia. 2011 Jan;31(2):133-43.
  2. Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. Haas M, Spegman A, Peterson D, Aickin M &Vavrek D. The Spine Journal 2010; 10:117-128.