Science In Brief

Chiropractic Literature Review

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The Study: The effect of manual therapy techniques on headache disability in patients with tension-type headache.

The Facts:

  1. Tension headaches are the most common primary type of headache.
  2. Unfortunately "there is no clear evidence" which tells us which type treatment is most effective for this condition.
  3. The authors looked at three treatment types: "suboccipital soft tissue inhibition" (deep pressure applied to this area), manipulation of the CO-C1 area and a combination of the two techniques. They also had a control group which received no treatment.
  4. 76 patients (of whom 62 were female) completed the study.
  5. The patients received care for four sessions a week apart.
  6. The care was provided by two therapists.
  7. Suboccipital soft tissue inhibition alone was not shown to be superior to the control group.
  8. Manipulation alone reduced the disability of "the headache severity, frequency, functional and emotional aspects related to the condition."
  9. But combining manipulation with the suboccipital soft tissue inhibition reduced all those disabilities and in addition helped "other symptoms including photophobia, phonophobia and pericranial tenderness."

Take Home:

Manipulation by itself was helpful in this condition but when combined with suboccipital soft tissue inhibition, the results were further improved.

Reviewer's Comments:
The astute reader will note a similarity to an article in the Journal of Chiropractic Medicine upon which we reported previously. It was pretty much the same study which yielded the same type of result. The lead author is the same although the way the name is indexed is different in the two papers. No matter, what we can say is that manipulation by itself is helpful and manipulation combined with this type of soft tissue work in the suboccipital area is better. I'm happy to report on this article again and if the same author takes another bite of the apple I may report on it again, well maybe not.

Reviewer: Roger Coleman DC

Reference: Espi-Lopez G, Rodrigueq-Blanco C, Oliva-Pascual-Vaca A, Benitez-Martinez J, Lluch E, Falla D. The effect of manual therapy techniques on headache disability in patients with tension-type headache. Eur J Phys Rehabil Med. 2014 Apr 30. [Epub ahead of print]

Link to Abstract: http://www.ncbi.nlm.nih.gov/pubmed/24785463

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