Headaches in children are a common and often distressing condition that can significantly impact quality of life, school performance, and social interactions. While various types of headaches affect pediatric populations, cervicogenic headaches and the potential role of spinal manipulation in treatment have garnered increasing attention in recent years.
Types of Headaches in Children
Headaches in children can be classified into primary and secondary types. Primary headaches, such as migraine and tension-type headaches, are the most common. Secondary headaches, including cervicogenic headaches, result from underlying conditions or structural issues.
Cervicogenic Headaches
Cervicogenic headaches originate from disorders of the cervical spine and its components. These headaches are characterized by pain that typically starts in the neck or base of the skull and radiates to the front of the head. In children, cervicogenic headaches may be associated with poor posture, prolonged screen time, or neck injuries[1].
Impact on Children’s Lives
Recurrent headaches can have profound effects on children’s daily functioning:
- School Performance: Headaches can lead to decreased concentration and missed school days[1].
- Social Interactions: Pain may limit participation in activities with peers and family[1].
- Emotional Well-being: Children with recurrent headaches report higher levels of stress and depression compared to those without headaches[3].
Treatment Approaches
While various treatment options exist for pediatric headaches, including pharmacological interventions, there is growing interest in non-pharmacological approaches, particularly for cervicogenic headaches.
Spinal Manipulation as a Treatment Option
Chiropractic spinal manipulation has emerged as a potential treatment for headaches in children, especially for cervicogenic headaches. However, the evidence supporting its effectiveness is mixed and limited.
A recent randomized controlled trial (RCT) investigated the effect of chiropractic manipulation in 199 children aged 7-14 years with recurrent headaches. The study found that chiropractic spinal manipulation resulted in significantly fewer days with headaches compared to a sham manipulation procedure[3]. The number needed to treat (NNT) for a 20% improvement was 7, indicating a moderate effect size[3].
Additionally, the same study reported a better global perceived effect in the chiropractic manipulation group, with an odds ratio of 2.8 (95% CI: 1.5-5.3) and an NNT of 5[3]. However, there was no significant difference between groups for pain intensity during headache episodes.
It’s important to note that while these results are promising, they represent findings from a single study. A broader systematic review of spinal manipulation for pediatric headaches revealed inconclusive results, highlighting the need for more robust research in this area[4].
Safety Considerations
The safety of spinal manipulation in children is a crucial consideration. While serious adverse events appear to be very rare, minor side effects may occur, particularly in younger children[3]. A review of compensation claims following chiropractic treatment in Denmark and Norway between 2004 and 2012 found no reports of harm or injury resulting in compensation claims in children aged 0-18 years[1].
Conclusion
Headaches in children, including cervicogenic headaches, can significantly impact various aspects of their lives. While spinal manipulation shows some promise as a treatment option, particularly for cervicogenic headaches, the current evidence base is limited. More high-quality research is needed to establish the effectiveness and safety of spinal manipulation for pediatric headaches. In the meantime, a multidisciplinary approach considering both pharmacological and non-pharmacological interventions may be most beneficial for managing headaches in children.
Citations:
[1] https://chiromt.biomedcentral.com/articles/10.1186/s12998-019-0262-y
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337090/
[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7792176/
[4] https://bmcpediatr.biomedcentral.com/articles/10.1186/s12887-022-03781-6
[5] https://www.safercare.vic.gov.au/sites/default/files/2019-10/20191024-Final%20Chiropractic%20Spinal%20Manipulation.pdf
[6] https://www1.racgp.org.au/newsgp/clinical/baby-spinal-manipulation-sees-minister-request-urg
[7] https://www.childrenssunshinechiropractic.com.au/headaches/
[8] https://journals.sagepub.com/doi/full/10.1046/j.1468-2982.2002.00423.x