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Noninvasive treatments for headache.

David M Biondi1

  • 1Spaulding Rehabilitation Hospital, Headache Management Program, 125 Nashua Street, Boston, MA 02114, USA. dbiondi@partners.org

Expert Review of Neurotherapeutics
|June 9, 2005
PubMed
Summary

Physical therapy shows promise for tension-type headaches and migraines when combined with other therapies. However, strong evidence for many physical treatments for headache disorders is lacking, requiring cautious patient and physician judgment.

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Area of Science:

  • Neurology
  • Physical Medicine

Background:

  • Primary headache disorders frequently involve neck pain and muscle symptoms.
  • Physical treatments are commonly used for headache management.

Purpose of the Study:

  • To review the efficacy of physical modalities for primary and cervicogenic headaches.
  • To develop expert opinions on the utility and effectiveness of these treatments.

Main Methods:

  • Medical literature review of selected physical modalities.
  • Analysis of collected data to form expert opinions.

Main Results:

  • Physical therapy may be more effective than massage or acupuncture for tension-type headaches, especially in high-frequency cases.
  • Physical therapy combined with biofeedback, relaxation, and exercise is most effective for migraines.
  • Chiropractic manipulation shows weak evidence for tension-type headaches, with limited benefit for migraines.

Conclusions:

  • Strong evidence for the efficacy of many physical treatments in reducing headache frequency, intensity, duration, and disability is lacking.
  • Physical treatments should generally complement, not replace, validated therapies.
  • Future studies require rigorous scientific methods to improve the evidence base for safety and efficacy.

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