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Aug 17, 2023

The Effect of Osteopathic Manipulative Treatment on Primary Headache Disorders


Nearly one in six Americans experience active headache disorders. The two most prevalent primary headache disorders are tension-type headaches and migraines (Jara Silva et al., 2022).

Tension headaches are the most common type of headache across all age groups. Pain is usually dull in sensation and felt across the forehead and sides of the head, likened to a band squeezing around the head. The root of tension headaches can be traced back to a variety of emotional, environmental, and physical factors including poor health, sleep disturbances, anxiety, stress, and poor posture (Scripter 2018).

Migraines are the second most prevalent headache type. Pain is most often one sided, throbbing and may be accompanied by nausea, visual auras and light sensitivity. Migraines have been largely linked to genetics, in addition to environmental factors, such as weather change, light exposure, and air quality (Cerritelli et al., 2015).


Osteopathic Manipulative Treatment (OMT) consists of a variety of hands-on techniques used in conjunction with other standard of care modalities to achieve a more holistic approach. OMT may be utilized as an alternative or adjuvant therapy for headaches. Doctors of Osteopathic medicine (DO) recognize that there is a relationship between body structure and function and use this background to guide their treatment approach.


Jara Silva et al., 2018

This review analyzed 15 studies across 12 years to evaluate the evidence on the use of OMT in the management of headaches. OMT remains a possible treatment for tension headaches and migraines in regards to frequency, duration and severity of symptoms, and overall improvement in patient outcomes. The incorporation of OMT and other soft tissue techniques has the potential to decrease overall drug consumption in its relationship to headache symptom relief. Used in conjunction with other treatment modalities, OMT may produce a significant improvement of headache symptomatology.

Cerritelli et al., 2015

This randomized controlled trial looked to study the effect of OMT vs medication at managing chronic headaches in 105 participants. Patients received 8 treatments, across 6 months that consisted of one of three treatments: medication and OMT, medication and a sham treatment or medication only. The study showed a significant reduction in the occurrence of migraines, use of drugs, and overall pain and disability scores in the OMT treatment group. This review presents the idea that OMT is a clinically valid treatment option in the management of migraine headaches.

Deodato et al., 2019

In this study OMT treatment was compared to medication intervention in the management of tension headaches. Patients underwent a 3 month treatment period where they received either OMT treatment or medication. The goal was to determine how each treatment affected tension headache pain intensity, frequency and duration as well as for forward head posture. The result was a significant improvement in all areas following OMT treatment, including forward head posture


Cerritelli F, Ginevri L, Messi G, Caprari E, Di Vincenzo M, Renzetti C,
Cozzolino V, Barlafante G, Foschi N, Provinciali L. Clinical
effectiveness of osteopathic treatment in chronic migraine: 3-Armed
randomized controlled trial. Complement Ther Med. 2015 Apr;23(2):149-56.

Deodato M, Guolo F, Monticco A, Fornari M, Manganotti P, Granato A.
Osteopathic Manipulative Therapy in Patients With Chronic Tension-Type
Headache: A Pilot Study. J Am Osteopath Assoc. 2019 Aug 12.

Jara Silva CE, Joseph AM, Khatib M, Knafo J, Karas M, Krupa K, Rivera B, Macia A, Madhu B, McMillan M, Burtch J, Quinonez J, Albert T, Khanna D. Osteopathic Manipulative Treatment and the Management of Headaches: A Scoping Review. Cureus. 2022 Aug 9;14(8):e27830.

Scripter C. Headache: Tension-Type Headache. FP Essent. 2018 Oct;473:17-20.

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