SIB#443- Chiropractic and Headaches in Children.
The Study: Effectiveness of chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7–14 years - a randomised clinical trial
Overview: This study was a “two-arm, single blind, superiority randomised controlled trial” conducted in two private clinics; one chiropractic clinic and one pediatric practice both located in Denmark.
Key Points:
The study looked at 199 children (7-14 years of age) with a history of at least one headache weekly for the previous six months.
Children were divided into a “treatment” group and a control group.
The treatment group received chiropractic manipulation and the control group received sham manipulation over a four month period.
The number and a frequency of treatments in the chiropractic group varied according to the judgment of the administering chiropractor.
Chiropractic manipulation was “directed at specific, individually identified dysfunctions in the spine, pelvis and/or temporomandibular joints” and consisted of a “high-velocity, low-amplitude thrust, resulting in an audible cavitation.
Children in the control group received eight sham manipulations during the treatment period.
Sham manipulations were administered according to a “previously validated protocol, developed by Chaibi et al. and consisted of “low-amplitude, low-velocity gentle pushes in a broad non-specific contact away from the spinal column” so as to produce no joint cavitation and, in the case of sham cervical manipulation a “de-activated activator” instrument was used which produced only a clicking noise.
Throughout the four month study, the children (with help from their parents) answered a series of weekly text messages as to headache frequency, severity, and need for pain medication.
At the end of the study, any children in the sham group who were continuing to have severe headache were offered the opportunity to receive chiropractic care and children in the chiropractic group who were still symptomatic were afforded the option of seeking evaluation with the participating pediatrician.
Author’s Conclusions: “Chiropractic spinal manipulation resulted in fewer headaches and higher global perceived effect, with only minor side effects compared to the control (sham) group. It did not lower the intensity of the headaches.
Since the treatment is easily applicable, of low cost and minor side effects, chiropractic spinal manipulation might be considered as a valuable treatment option for children with recurrent headaches.” (emphasis ours)
Reviewer's Comments: Hmmm…where to start? Well first, I’m just really tired of talking about COVID-19 and wanted to get back to basics. Second, after 40 plus years in chiropractic, I remain a proponent of chiropractic care for children...So there. And finally, this study, like essentially all studies which look at the chiropractic adjustment, suffers from an inability to blind the treating doctor due to the inherent nature of the chiropractic adjustment. Consequently, it will be all too easily dismissed by critics of chiropractic both internal and external. And that’s exactly why I thought it needed to be in this week’s review.
Reviewer: Mark R. Payne DC
Reference: Lynge S, Dissing K, Vach, W, Christensen H, Hestebaek L. Effectiveness of chiropractic manipulation versus sham manipulation for recurrent headaches in children aged 7–14 years - a randomised clinical trial. Chiropr Man Therap. 2021; 29: 1. Published online 2021 Jan 7. doi: 10.1186/s12998-020-00360-3
Link to Full Text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC779