Efficacy of manual therapy on anxiety and depression in patients with tension-type headache (TTH)

Health specialists at the the University of Valencia in Spain carried out a randomised controlled clinical trial on 84 participants diagnosed with tension-type headache (TTH) related to depression and anxiety. According to a study published in Elsevier International Journal of Osteopathic Medicine.

The aim of the trial was to assess the efficacy of three manual therapy treatments for reducing TTH-related anxiety and depression headaches, their frequency and pain intensity.

TTH is one of the most common types of primary headaches, which negatively effects and impedes on a person’s work and social life.

Those participating in the Spanish trial were said to have had increased tenderness in peri-cranial myofascial tissues and several trigger points, which suggests that tension in the craniocervical muscles maybe a possible physiological cause of tension-type headaches.

The 84 participants, suffering from TTH, were divided into four groups. Group one received soft tissue treatment (ST), the second group was treated with articulatory techniques (AT) whilst the third group underwent a combination of both AT and ST techniques. Group four was the control group.

Treatments were administered over a four week period with post-treatment assessment and a follow up after one month.

Physiotherapy and muscle relaxation therapies are effective treatments for this kind of muscular tension. Muscle relaxation is a non-invasive alternative to medication-based treatments and shows positive results in reducing headache frequency, duration and intensity.

Manual therapy aimed at active trigger points (sternocleidomastoid muscle) is an effective technique to improve cervicogenic headaches and movement.

In addition the articulatory mobility and muscle relaxation techniques, when applied to the craniocervical soft tissues and joints of the sub-occipital region, not only improve the tension-type headaches, but also reduced the adverse psychological states of depression and anxiety.

Articulatory Techniques (AT), which included both articulatory and high-velocity thrust manipulation, applied to the sub-occipital region, was more effective than a soft tissue technique (ST) in reducing negative emotional states.

Overall, all treatments applied in this study were shown to have a moderate, yet positive effect, in reducing the negative, secondary effects of depression and anxiety in TTH.