Free
The Somatic Connection  |   January 2017
Manual Therapy Lowers Psychological Aggravations in Patients WIth Tension-Type Headache
Author Notes
  • Research Assistant, Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, California 
  • University of California, San Diego School of Medicine 
Article Information
The Somatic Connection   |   January 2017
Manual Therapy Lowers Psychological Aggravations in Patients WIth Tension-Type Headache
The Journal of the American Osteopathic Association, January 2017, Vol. 117, 59-60. doi:10.7556/jaoa.2017.012
The Journal of the American Osteopathic Association, January 2017, Vol. 117, 59-60. doi:10.7556/jaoa.2017.012
Essí-López GV, López-Bueno L, Vicente-Herrero MT, Martinez-Arnau FM, Monzani L. Efficacy of manual therapy on anxiety and depression in patients with tension-type headache: a randomized controlled clinical trial [published online June 8, 2016]. Int J Osteopath Med. doi:10.1016/j.ijosm.2016.05.003 
Research by this physiotherapist team in Spain on tension-type headache (TTH) showing the benefit of manual therapy has been reviewed in previous editions of “The Somatic Connection.”1,2 Tension-type headache, the most common form of headache, is proposed to increase anxiety and depression in this patient population. This study was a pragmatic, double-blind, randomized controlled clinical trial to assess the effect of manual medicine on the mental well-being of patients with TTH. 
The study appraised 84 pharmacologically stable patients with a diagnosis of TTH (episodic or chronic) lasting longer than 6 months. Pregnant patients and those with vascular injury, vertebrobasilar insufficiency, arthritis, nausea, neurologic disorders, or a headache diagnosis other than TTH were excluded. Participants were randomly assigned to 1 of 3 treatment groups receiving articulatory techniques (AT), soft tissue treatment (ST), or a combination of AT and ST, or a control group. The State-Trait Anxiety Inventory was used to assess anxiety, and the Beck Depression Inventory was used to assess depression. Participants were blinded to the treatment groups, and clinicians were blinded to the nature and purpose of the study. All intervention groups received 20-minute weekly treatments, which were applied with the patient in the supine position, for 1 month. Likewise, the control group rested supine for 10 minutes with the same evaluation and follow-up. Within- and between-group effects were measured with covariance. The Cohn κ was used to assess changes before and after interventions. 
The authors concluded that all intervention groups experienced some decrease in anxiety and depression compared with the control group. Patients who received AT or both AT and ST showed greater decrease than those who only received ST. Nonetheless, differences were observed between TTH types, which need to be further studied before specific treatment recommendations can be made definitively. 
Consistent with osteopathic philosophy, this study suggests that osteopathic manipulative treatment, which aligns with the interventions used in this study, reduces pain and dysfunction but also may have mental and emotional benefits. 
References
Burnham T, Higgins DC, Burnham RS, Heath DM. Effectiveness of osteopathic manipulative treatment for carpal tunnel syndrome: a pilot project. J Am Osteopath Assoc. 2015;115(3):138-148. doi:10.7556/jaoa.2015.027 [CrossRef] [PubMed]
Sucher BM. Carpal tunnel syndrome: ultrasonographic imagining and pathologic mechanisms of median nerve compression. J Am Osteopath Assoc. 2009;109(12):641-647. [CrossRef] [PubMed]