Electrical dry needling, spinal manipulations, joint mobility and exercises are effective treatment options for cervicogenic headaches (headaches originating from the neck). Electrical dry needling and manipulations are superior at improving headache intensity, frequency and disability compared to joint mobility and exercise. Benefits were observed at 3 month follow up after treatment. 

Cervicogenic headaches (CGH, neck-related headaches), account for 20% of all headaches, and as high as 53% of headaches following whiplash injury. Whiplash injuries are often experienced after car accidents. Neck related headaches are defined as one sided headache or pain, made worse with pressure over the affected muscles, loss of neck range of motion, and triggered by awkward or sustained neck movements. Interventions that include a combination of treatments seem to be more effective at treating neck-related headaches than stand-alone treatments. 

In this article, participants were an average of 40 years old, with most taking medication at least once per day or several times per weeks, experienced an average headache intensity of 6/10, with most headaches lasting between 11-24 hours. Participants were separated into two treatment groups. One group received dry needling with stimulation and spinal manipulation. The other group received joint mobility and strength training exercises. Measurements included neck pain, headache frequency and duration, disability and medication use. These measurements were taken at baseline (prior to therapy), 1 week, 4 weeks and 3 months after the last treatment session. Treatments consisted of twice weekly interventions for 4 weeks. 

The findings demonstrated that both groups improved significantly in all outcome measures. However, the dry needling and manipulation group experienced much greater improvements in headache intensity, frequency and duration, less medication use and less disability compared to the joint mobility and exercise group.