Techniques used by manipulative physiotherapists in the management of headaches

This study aimed to identify the techniques used by manipulative physiotherapists in the management of headaches. Two hundred and two patients with headache presented to 44 Victorian trained manipulative physiotherapists (MPTs) who completed questionnaires to determine techniques used. Upper cervical (O-C3) passive accessory intervertebral movement was the most frequently used technique (84.7 per cent). Techniques such as manipulation (42.1 per cent), soft tissue massage (35.6 per cent), postural education/advice (30.2 per cent), muscle stretches (29.2 per cent), traction (26.7 per cent) and postural exercises (21.3 per cent) were usually introduced during the initial consultation, whereas passive physiological intervertebral movements (17.3 per cent), muscle retraining (16.8 per cent) and neural techniques (5.4 per cent) were more commonly introduced in later sessions. The low incidence of muscle retraining was surprising and may not reflect contemporary practice. The results indicate that the clinicians studied employ a diverse range of techniques in the management of headaches.