Studies support manual therapy for migraine or tension type headache

Two separate national guidelines on migraine and tension type headache published recently both recommend manual therapy as non-pharmacological treatment of the two kinds of headache. The recommendations are based on weak evidence.

Both guidelines are based on systematic literature searches and a questionnaire involving 380 patients with migraine or tension type headache. The questionnaire was used to clarify the patients’ expectations for the treatment. The recommendations only concern manual therapy, not soft tissue treatment such as trigger point treatment.

The purpose of the studies was to offer updated guidelines on some widely used non-pharmacological treatment techniques used to treat migraine or tension type headache, including manual therapy.

In both instances, the search of the scientific literature determined that manual therapy did not lead to serious adverse effects and that manual therapy can have a positive effect on the frequency of pain and the patient’s quality of life.

The recommendations are not based on the available weak evidence only, but also on the absence of serious adverse effects and the patients’ preferences. More than half the patients who completed the questionnaire indicated that they would seek the same treatment in the future if necessary.

The guidelines were formulated by Dagmar Beier (Odense University Hospital, University of Southern Denmark), Henriette E Callesen (methodologist), Louise N Carlsen (Rigshospitalet Glostrup), Kirsten Birkefoss (Danish Health Authority), Hanna Tómasdóttir (Danske Osteopater), Hanne Wűrtzen (Rigshospitalet), Henrik Wulff Christensen (the Chiropractic Knowledge Hub), Lotte S Krøll (Rigshospitalet Glostrup), Mette Jensen (Doktor Jensen Akupunkturklinik), Christel V Høst (Rigshospitalet Glostrup) and Jakob M Hansen (Odense University Hospital, University of Southern Denmark).

For more information read the two papers in full:

Dagmar Beier, Henriette E Callesen, Louise N Carlsen, Kirsten Birkefoss, Hanna Tómasdóttir, Hanne Wűrtzen, Henrik W Christensen, Lotte S Krøll, Mette Jensen, Christel V Høst, Jakob M Hansen. Manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education in migraine treatment. A systematic review and meta-analysis. Sage Journals, 2021. https://journals.sagepub.com/doi/10.1177/03331024211034489

Lotte Skytte Krøll, Henriette Edemann Callesen, Louise Ninett Carlsen, Kirsten Birkefoss, Dagmar Beier, Henrik Wulff Christensen, Mette Jensen, Hanna Tómasdóttir, Hanne Würtzen, Christel Vesth Høst, Jakob Møller Hansen. Manual joint mobilisation techniques, supervised physical activity, psychological treatment, acupuncture and patient education for patients with tension-type headache. A systematic review and meta-analysis. The Journal of Headache and Pain, 2021 https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-021-01298-4

 

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