2026-04-26T22:08:08Zhttps://uvadoc.uva.es/oai/request

oai:uvadoc.uva.es:10324/770072025-07-30T19:00:44Zcom_10324_1138com_10324_931com_10324_894col_10324_1226

00925njm 22002777a 4500 dc Ceballos Laita, Luis author Ernst, Edzard author Carrasco Uribarren, Andoni author García García, Daniel author Jiménez del Barrio, Sandra author 2025 Introduction: Patients with headaches often seek complementary and alternative therapies, including chiropractic care. Chiropractic spinal manipulation is one of the most commonly used techniques for these patients; however, its effectiveness remains unclear. This systematic review aimed to evaluate the effectiveness of chiropractic spinal manipulation in reducing headache days, episode duration, episode intensity, and medication intake in patients with headaches. Methods: MEDLINE (Pubmed), PEDro, SCOPUS, Cochrane Library and Web of Science databases were searched from inception to April 2024. PICO search strategy was used to identify randomized controlled trials applying chiropractic spinal manipulations versus sham manipulation, no additional intervention, or other conservative non-pharmacological interventions in patients with headaches. Eligible studies and data extraction were con- ducted independently by two reviewers. Quality of the studies was assessed with Physiotherapy Evidence Database scale, and risk of bias with Cochrane Collaboration tool. Certainty of the evidence was evaluated using GRADE approach. Results: Eight studies ranging from low to high methodological quality were included in the synthesis without a meta-analysis. The results were categorized into three subgroups: chiropractic manipulation versus sham, chiropractic manipulation versus control, and chiropractic manipulation versus deep friction massage. Among the five studies comparing chiropractic manipulation to sham, two found a significant reduction in the number of headache days. Of the three studies comparing chiropractic manipulation to a control, one reported a decrease in headache episode duration. No significant differences were observed for any other variable across the subgroups. The certainty of evidence was downgraded to very low. Conclusions: It is uncertain if chiropractic spinal manipulation is more effective than sham, control, or deep friction massage interventions for patients with headaches. PROSPERO registration number: CRD42024518480 European Journal of Integrative Medicine, 2025, vol. 76, p. 102462 1876-3820 https://uvadoc.uva.es/handle/10324/77007 10.1016/j.eujim.2025.102462 102462 European Journal of Integrative Medicine 76 Is chiropractic spinal manipulation effective for the treatment of cervicogenic, tension-type, or migraine headaches? A systematic review