Spinal Manipulation for Tension-type Headache

KEYWORDS:
• chiropractic
• headache
• manipulation, spinal
• spinal manipulation
• tension headache

To the Editor: As an osteopathic family physician who incorporates osteopathic manipulation therapy (OMT) into my daily practice, I was concerned by the design and conclusions of the article by Drs Bove and Nilsson.¹ The article should lead one to conclude only that the particular method of manipulation used was not helpful.

Before dismissing the role of manipulation from the therapeutic armamentarium for headaches, it is important to look more closely at other relevant factors. First, OMT is consistently more comprehensive than the treatment described in this study (techniques were confined to the cervical spine and musculature surrounding the cervical and upper thoracic spine). Holistic therapy mandates that one treats the whole body, not just the affected part. By so doing, OMT is often successful in reducing symptoms, improving outcomes, decreasing direct and indirect costs (such as physician office visits), as well as decreasing the frequency of treatments.^{2 …}