A Comparison of Selected Osteopathic Treatment and Relaxation for Tension-Type Headaches


  • Rosemary E. Anderson BSc.PT, DO (MP),

  • Caryn Seniscal RMT, DO (MP)

  • From the Toronto Rehabilitation Institute, Toronto, Canada (Anderson); Canadian College of Osteopathy, Toronto, Canada (Seniscal).

Address all correspondence to Rosemary E. Anderson, Toronto Rehabilitation Institute, 550 University Avenue, Neurology Program, Room 705, Toronto ON M5G 2A2. Canada.


Objective.—The objective of this study was to compare the effects of osteopathic treatment and progressive muscular relaxation (PMR) exercises on patients with tension-type headache (TTH).

Background.—Relaxation is generally accepted as a treatment for TTH. Osteopathy is considered by some practitioners to be useful for headache management but there is limited scientific evidence regarding the effectiveness. This study compares relaxation and relaxation plus selected osteopathic techniques in the treatment of people with TTH.

Design.—This was a single-blind, randomized, clinical study using an experimental design. Twenty-nine patients with TTH according to the International Headache Classification Subcommittee, 2004, were recruited for this study and randomly placed in either a control or experimental group. Both groups practiced PMR exercises at home while the experimental group also received 3 osteopathic treatments.

Method.—All participants recorded headache frequency and intensity in a headache diary (HD) for 2 weeks pretreatment, and continued recording during the treatment period until reassessment for a total of 6 to 7 weeks. All tests of significance were set at P≤ .05.

Results.—Twenty-six people completed the study. Results indicated that the number of Headache Free Days Per Week was significantly improved (P= .016) in the experimental group. Two other measures, the Headache Degree of Improvement (P= .075) and the HD rating (P= .059), which combine headache frequency and intensity, did not meet our criteria for statistical significance but both scores are <.10 indicating a trend toward improvement in the experimental group that is clinically significant. The HD Rating also showed that the experimental group improved 57.5%, while the control group improved 15.6%. The intensity of headache did not show a significant improvement (P= .264).

Conclusion.—The people in this study who did relaxation exercises and received 3 osteopathy treatments had significantly more days per week without headache than those who did only relaxation exercises.