Efficacy of Manual and Manipulative Therapy in the Perception of Pain and Cervical Motion in Patients with Tension-type Headache: A Randomized, Controlled Clinical Trial

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SOURCE:   J Chiropr Med. 2014 (Mar);   13 (1):   4—13

Espí-López Gemma V., PhD, PT, and Gómez-Conesa Antonia, PhD, PT

Professor, Physiotherapy Department,
University of Valencia, Spain

OBJECTIVE:   The purpose of this study was to evaluate the efficacy of manipulative and manual therapy treatments with regard to pain perception and neck mobility in patients with tension-type headache.

METHODS:   A randomized clinical trial was conducted on 84 adults diagnosed with tension-type headache. Eighty-four subjects were enrolled in this study: 68 women and 16 men. Mean age was 39.76 years, ranging from 18 to 65 years. A total of 57.1% were diagnosed with chronic tension-type headache and 42.9% with tension-type headache. Participants were divided into 3 treatment groups (manual therapy, manipulative therapy, a combination of manual and manipulative therapy) and a control group. Four treatment sessions were administered during 4 weeks, with posttreatment assessment and follow-up at 1 month. Cervical ranges of motion pain perception, and frequency and intensity of headaches were assessed.

RESULTS:   All 3 treatment groups showed significant improvements in the different dimensions of pain perception. Manual therapy and manipulative treatment improved some cervical ranges of motion. Headache frequency was reduced with manipulative treatment (P < .008). Combined treatment reported improvement after the treatment (P < .000) and at follow-up (P < .002). Pain intensity improved after the treatment and at follow-up with manipulative therapy (P < .01) and combined treatment (P < .01).

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CONCLUSIONS:   Both treatments, administered both separately and combined together, showed efficacy for patients with tension-type headache with regard to pain perception. As for cervical ranges of motion, treatments produced greater effect when separately administered.

KEYWORDS:   Musculoskeletal manipulations; Pain perception; Range of motion; Rehabilitation; Spinal manipulation; Tension-type headache


From the FULL TEXT Article:


Tension-type headache (TTH) is the most prevalent type of the primary headache categorized by the International Headache Society, [1] and it is a health problem with great socioeconomic impact. [2, 3] Both episodic tension-type headache (ETTH) and chronic tension-type headache (CTTH) have important repercussions on the quality of life, affecting the working and social spheres, as well as the activities of daily living. [4]

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