Effectiveness of the Treatment of Tension-type Headache With Manual and Manipulative Therapy

University of Valencia

Status: Completed

Conditions: Tension-type Headache

Treatments: Other: Manual Therapy; Other: placebo treatment

Study type: Interventional

Funder types: Other

Identifiers

NCT01601015

UVT002

Details and patient eligibility

About

Background. Tension-type headache (TTH) is the most common form of primary headache and it is a real problem for the subjects suffering from it. Until now, physiotherapy treatments have included different techniques combined together, without establishing which of them is more effective.

Objective. The purpose of this study is to know the effectiveness of manipulative and manual therapy treatments, with regard to pain perception and neck mobility in patients with tension-type headache.

Methods: A double-blind, randomized clinical trial was conducted, with 84 patients diagnosed with tension-type headache, divided into three treatment groups -manual therapy, manipulative therapy, and a combination of both techniques-, and a placebo control group. Four treatment sessions were administered during four weeks, with post-treatment assessment, and follow-up at one month. Cervical ranges of motion were assessed (CROM device), as well as pain perception (McGill Pain Questionnaire), and frequency and intensity of headaches (weekly register).

Enrollment: 84 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Subjects aged between 18 and 65 years

• Diagnosis of frequent ETTH and CTTH

• Having headache episodes on more than 1 day per month

• Headache episodes lasting from 30 minutes to 7 days

• Headaches having at least 2 of the following characteristics:

  • Bilateral location of pain
  • Pressing non pulsating quality
  • Mild or moderate intensity
  • Not aggravated by physical activity

• Sufferers may present photophobia, phonophobia, nausea or vomiting

• Headache may be associated with pericranial tenderness

• Suffering from TTH for over 3 months

• Subjects being under pharmacological control

Exclusion criteria

• Patients with infrequent ETTH, and patients with probable TTH in its frequent and infrequent forms.

  • Headache that is aggravated by head movements.
  • Metabolic or musculoskeletal disorders with symptoms similar to headache
  • Previous neck trauma
  • Vertigo, dizziness, arterial hypertension.
  • Joint stiffness, arteriosclerosis or advanced degenerative osteoarthritis
  • Patients with heart devices
  • Patients in process of pharmacological adaptation
  • Excessive emotional tension
  • Neurological disorders
  • Laxity of neck soft tissues
  • Radiological alterations
  • General hypermobility or hyperlaxity
  • Joint instability
  • Pregnancy

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Triple Blind

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84 participants in 4 patient groups, including a placebo group

Manual therapy

Experimental group

Description:

Manual therapy of Suboccipital soft tissue Inhibition treatment aims to release the suboccipital muscle spasm that maintains the occiput-atlas-axis joint dysfunction.

Treatment:

Other: Manual Therapy

Other: Manual Therapy

Other: Manual Therapy

Occiput-atlas-axis joint manipulation

Experimental group

Description:

Is bilaterally administered. The aim of restoring the mobility of joints between occiput, atlas and axis, which enables to correct a global joint dysfunction

Treatment:

Other: Manual Therapy

Other: Manual Therapy

Other: Manual Therapy

Combined treatment

Experimental group

Description:

The group receiving combined treatment received the two previous techniques exactly with the same sequence.

Treatment:

Other: Manual Therapy

Other: Manual Therapy

Other: Manual Therapy

Control group

Placebo Comparator group

Description:

Control group not receive treatment and stayed in this position for 10 minutes

Treatment:

Other: placebo treatment