The 3 articles1-3 on head pain reviewed in the previous pages are among a growing literature base that shows the benefit of osteopathic manipulative treatment (OMT) for patients with various types of head pain. The Journal of the American Osteopathic Association (JAOA) has published reviews,4-9 case studies,10-13 a retrospective study,14 and a clinical research article on head pain.15 The case studies all show successful use of OMT for posttraumatic head pain, after tooth extraction, and in the rare condition of “daily persistent headache.” The retrospective study showed that the cost of treating patients with migraines was much less if OMT was applied than if OMT was not applied. Of note, no adverse events were reported in these studies. Clearly, OMT for head pain represents fertile ground for research at the clinical trial level.
If we include temporomandibular joint (TMJ) pain as head pain, 2 additional JAOA articles16,17 should be noted. Both articles describe OMT procedures that were beneficial in the reported case studies for relief of TMJ pain, and again no adverse events were reported.
“The Somatic Connection” column of the JAOA has also reviewed a number of clinical trials on the application of osteopathic manipulative therapy (OMTh; manipulative care provided by a foreign-trained osteopath) in patients with head pain.18-20 Patients with migraine headache have received relief from OMTh,18,20 including craniosacral therapy, and benefit was shown for tension-type headache.19 Studies showing benefit in cases of tension-type headache,21-24 migraine,25 facial pain, and TMJ,26,27 as well as head pain associated with traumatic brain injury28 by applying manual therapy were also reviewed in “The Somatic Connection.”
As a body of literature, I believe there is substantial evidence supporting the use of OMT and manual therapy in virtually all types of head pain cases. My clinical experience certainly supports this view. With another 1 or 2 clinical trials, there may be enough data to conduct a systematic review and meta-analysis.
References
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