Abstract
This study aims to evaluate the immediate analgesic effect and safety of cervical localized rotation manipulation (CLRM) combined with cervical Huatuo-Jiaji electroacupuncture (CHJE) on cervicogenic headache (CEH) in a retrospective controlled study. A total of 300 patients with CEH who visited the pain and rehabilitation departments of a hospital from July 2024 to March 2025 were included and assigned to 3 groups according to their received treatments: CLRM, CHJE, and combined CLRM + CHJE (100 cases each). Primary outcomes included headache intensity (visual analog scale, VAS), pressure pain threshold, and somatosensory evoked potential-N13 latency. Secondary measures were cervical range of motion, serum β-endorphin and 5-hydroxytryptamine levels, headache frequency and duration, and adverse events. All groups showed significant improvement immediately after treatment, while the combined CLRM + CHJE group exhibited greater reductions in VAS scores, higher pressure pain threshold, and shorter somatosensory evoked potential-N13 latency compared with single interventions. The immediate analgesic response rate (≥50% VAS reduction) was highest in the combined group (71%). The combined therapy also improved cervical mobility, elevated serum β-endorphin and 5-hydroxytryptamine levels, and reduced associated symptoms. Only mild, self-limited adverse events were observed, with no serious complications reported. This retrospective controlled study suggests that CLRM combined with CHJE may provide superior immediate pain relief and functional improvement for patients with CEH compared with either treatment alone. The combined protocol appears to be safe, rapid in onset, and well tolerated. However, these findings reflect only short-term outcomes and should be interpreted cautiously until confirmed by prospective studies with long-term follow-up.