Who Responds to Spinal Manipulation, Dry Needling and Exercise for Cervicogenic Headache: A Secondary Analysis of a Multicenter Randomized Trial

Physical therapists and physical therapist assistants who treat neck-related headache, plus clinicians who want a clear read on what baseline patient characteristics do and do not forecast about response to manual therapy, dry needling and exercise.

Licensed physical therapists and physical therapist assistants in outpatient orthopedic, spine, sports and headache-focused settings. The material is also relevant to athletic trainers, chiropractors and occupational therapists who see patients with neck-related headache.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course is built on a single source document, a secondary analysis of a previously published multicenter randomized controlled trial of adults with cervicogenic headache. Every finding, figure and conclusion presented in this course traces to that paper.

Dunning J, Young I, Prall J, Mourad F, Bliton P, Kerry R, Escaloni J, Maselli F, Fernández-de-las-Peñas C. Predictors of response to spinal manipulative therapy, dry needling and exercise in patients with cervicogenic headache. Musculoskeletal Science and Practice. 2026;86:103662. https://doi.org/10.1016/j.msksp.2026.103662

Parent trial registration: ClinicalTrials.gov NCT02373605.

A note on interests declared in the source

The authors reported that the lead author directs the American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy and that several co-authors are senior faculty of that fellowship, which provides postgraduate training in spinal manipulation and dry needling, among other topics. The authors reported that no funding was received for the study. Those disclosures appear in the paper itself and are repeated here so learners can weigh them.

After completing this course, you will be able to:

1. Describe the patient population, the treatment program and the definition of a successful outcome used in this secondary analysis of a cervicogenic headache trial.
2. Name the two baseline factors that predicted a successful three-month outcome and state which baseline and treatment-related factors did not.
3. Explain the limits the authors placed on their own findings, including why they urged caution about the sex finding and what a prognostic analysis can and cannot show.

1. Start Here: How This Course Works
2. Podcast: Predicting Who Gets Better After Manual Therapy for Neck-Related Headache (about ten minutes)
3. The Question Behind the Analysis and the Patients Who Were Studied
4. Inside the Trial: Treatments, Follow-Up and How Success Was Defined
5. What Tracked With a Successful Outcome — and What Did Not
6. Where the Analysis Runs Out of Road
7. Reading These Findings Alongside the Earlier Prognostic Studies
8. Key Takeaways
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course is built on a single source document, a secondary analysis of a previously published multicenter randomized controlled trial of adults with cervicogenic headache. Every finding, figure and conclusion presented in this course traces to that paper.
2. Dunning J, Young I, Prall J, Mourad F, Bliton P, Kerry R, Escaloni J, Maselli F, Fernández-de-las-Peñas C. Predictors of response to spinal manipulative therapy, dry needling and exercise in patients with cervicogenic headache. Musculoskeletal Science and Practice. 2026;86:103662. https://doi.org/10.1016/j.msksp.2026.103662
3. Parent trial registration: ClinicalTrials.gov NCT02373605.
4. A note on interests declared in the source
5. The authors reported that the lead author directs the American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy and that several co-authors are senior faculty of that fellowship, which provides postgraduate training in spinal manipulation and dry needling, among other topics. The authors reported that no funding was received for the study. Those disclosures appear in the paper itself and are repeated here so learners can weigh them.