Headaches can be driven by a variety of sources and often are multifactorial in nature. Common headache types treated by our Physical Therapists in our Boulder and Lafayette offices include tension, migraine, and cervicogenic headache. This final type of headache is driven from the joints and musculature of the neck as it meets the base of our skull. Commonly patients in this category have a history of neck pain, their headache symptoms are aggravated by neck movements and postures, and headache symptoms run along the back and side of the head. Multiple Physical Therapy research trials have shown neck spinal manipulation and exercise to be effective treatments for this condition. A recent study was conducted to determine the benefit of mid back, or thoracic, spinal manipulation.

McDevitt and colleagues randomized 48 patients with cervicogenic headache to either 6 sessions of thoracic spinal manipulation or no treatment (JMMT. 2022). Participants were then crossed over to the other group at 4 weeks to complete the randomized, controlled trial crossover trial. Authors collected outcomes including headache and neck disability, as well as, the patient’s perceived rating of symptoms improvement. Authors reported no difference on groups on headache symptoms between those who received or did not receive thoracic spinal manipulation, but patients reported greater perceived recovery in the spinal manipulation. Conversely, clinical practice and Physical Therapy research has consistently shown the benefits of upper cervical manipulation for patients in this category of headache.