Efficacy of manual therapy on frequency and intensity of pain, anxiety and depression in patients with tension-type headache. A randomized controlled clinical trial

Tension-type headache (TTH) is a highly prevalent disorder with a significant socio-economic impact and psychological effects for TTH participants. The purpose of this study was to test the efficacy of three manual therapy TTH treatments with regard to the reduction of TTH-related anxiety and depression were also addressed. A clinical trial was conducted on 84 participants suffering from tension-type headache forming 4 groups: the first group received suboccipital soft tissue treatment (ST); the second group was treated with articulatory techniques (AT); the third group underwent a combination of both techniques (ST and AT), while the forth group was the control group. Treatment sessions were administered over four weeks, with post-treatment assessment, and follow-up at one month. We conducted Repeated measures Analysis of Covariance (RM-MANCOVA) to evaluate the effect of treatment on between and within-subject conditions and their interaction on reported depression and anxiety. While all treatments prove to be effective in reducing its associated psychological symptoms (depression, anxiety), their efficacy varied between treatments, TTH types and the elapsed time between measurements.

Overall, our findings suggest that treatments including articulatory techniques are more efficient than soft tissue techniques, or a combination of both, for the reduction of physiological symptoms in TTH participants and, as a secondary benefit, reduce anxiety and depression levels in these participants.