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Spinal Manipulation Lowers Likelihood of Butalbital Rx With Tension-Type Headache

Similar pattern seen for medication overuse headache versus matched controls not receiving SMT

By Lori Solomon HealthDay Reporter

WEDNESDAY, Dec. 11, 2024 (HealthDay News) — Adults receiving chiropractic spinal manipulative therapy (SMT) for tension-type headache have a significantly lower likelihood of butalbital prescription, according to a study published online Nov. 29 in Health Science Reports.

Robert J. Trager, D.C., from the Case Western Reserve University School of Medicine in Cleveland, and colleagues assessed whether receiving chiropractic SMT for tension-type headache impacts receipt of butalbital prescription. The analysis included 3,116 matched patients with tension-type headache receiving and not receiving SMT.

The researchers found that the incidence of butalbital prescription was lower in the SMT cohort versus the non-SMT cohort (SMT: 1.7 percent; non-SMT: 3.8 percent; risk ratio, 0.46). The SMT cohort also had a lower incidence of medication overuse headache versus the non-SMT cohort (SMT: 0.5 percent; non-SMT: 1.2 percent; risk ratio, 0.44). 

“Adults receiving chiropractic SMT had a significantly lower likelihood of butalbital prescription and, tentatively, medication overuse headache compared to matched controls not receiving SMTs,” the authors write. “These findings reinforce clinical practice guidelines already recommending SMT for tension-type headache. However, additional research is needed to corroborate our results and examine the association between a broader variety of nonpharmacologic interventions and butalbital prescription and medication overuse headache.”


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