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Research
Can ultrasounds accurately measure the muscles that support your neck?
Diagnostic ultrasound offers a safe, non-invasive way to evaluate muscle function in real time. This study developed a new method for measuring the deep neck flexor muscles in the upper cervical spine and found that the technique is reliable and consistent. Establishing a dependable way to assess these muscles is an important step toward improving the evaluation and treatment of neck pain and headaches.
O'Halloran B, Devorski L, Knapp M. (2025). Reliability of muscle thickness measurements of the deep neck flexors in the upper cervical spine. Journal of Bodywork and Movement Therapies, 43, 152–158. https://doi.org/10.1016/j.jbmt.2025.04.030
How do patients know when they’re truly recovered from neck pain?
Patients with neck pain often know when they are truly getting better, and their perception of recovery provides valuable information for clinicians. This study found that a simple question about how close patients feel to being "back to normal" closely matched improvements in pain, function, and daily activities. The findings support using patient-reported recovery as an important part of guiding treatment and determining when patients are ready to move forward independently.
O'Halloran B, Cook CE, Oakley E. (2021). Criterion validation and interpretability of the Single Assessment Numeric Evaluation (SANE) of self-reported recovery in patients with neck pain. Musculoskeletal Science and Practice, 56, 102467. https://doi.org/10.1016/j.msksp.2021.102467
Is Your Sinus Headache Really Coming From Your Neck?
Neck pain may play a meaningful role in sinus‑related headaches, and many patients feel this neck discomfort affects their quality of life. Upper cervical spine dysfunction appears to be especially common in people with HAR. While we can’t yet say whether one causes the other, the findings from this study highlight the importance of evaluating the neck — not just the sinuses — when treating sinus‑related headaches.
Petersen, S., O’Halloran, B., Swanson, B. T., Luth, A. M., & Learman, K. E. (2025). Neck pain associated with headache attributed to rhinosinusitis: an observational study. Journal of Manual & Manipulative Therapy, 33(2), 158–166. https://doi.org/10.1080/10669817.2024.2448568
Does the type of hands-on treatment matter for neck-related headaches?
Many headaches actually originate from the neck, a condition known as cervicogenic headache. This study found that both spinal manipulation and spinal mobilization, when combined with exercise, were equally effective at reducing headache symptoms, neck pain, and disability. Rather than one technique being superior, the findings highlight the importance of matching treatment to the individual patient and using an evidence-based approach to care.
Lerner-Lentz A, O'Halloran B, Donaldson M, Cleland JA. (2021). Pragmatic application of manipulation versus mobilization to the upper segments of the cervical spine plus exercise for treatment of cervicogenic headache: A randomized clinical trial. Journal of Manual & Manipulative Therapy, 29(5), 267–275. https://doi.org/10.1080/10669817.2020.1834322