Manual therapy and quality of life in people with headache: systematic review and meta-analysis of randomized controlled trials

Review written by Shruti Nambiar info

Key Points

  1. Tension-type headache (TTH), migraine headache (MH) and cervicogenic headache (CGH) are the most prevalent forms of headache with significant socio-economic burden.
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According to the International Headache Society headaches are classified into: primary headaches, secondary headaches and other headache disorders (1). Migraine headache (MH) and tension-type headache (TTH) are types of primary headaches - a headache disorder not caused by or attributed to another disorder (1). Cervicogenic headaches (CGH) are secondary headaches which is a headache disorder caused by another underlying disorder such as a neck injury, infection, etc (1). The first line of treatment is often pharmacological. Manual therapy is pursued by several patients as an alternative form of non-pharmacological treatment since prolonged use of medications comes with a risk of drug abuse or medication overuse headache (MOH). This review aimed to ascertain whether manual therapy is more effective at improving the quality of life of headache patients compared to pharmacological care or placebo.

Primary headaches are not caused by or attributed to another disorder, whereas secondary headaches are caused by another underlying disorder, such as a neck injury.
These findings support the use of manual therapy as an adjunctive therapy along with exercise and education for the treatment of headaches.


Studies were selected by screening electronic databases. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

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