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Are Manual Therapies Effective in Reducing
Pain From Tension-Type Headache? A
Systematic Review
Fernandez-de-Las-Penas C, Alonso-Blanco C, et al.
Posted: January 2007  
Clin J Pain. 2006;22:278-285

Objectives:   A systematic review was performed to establish whether manual therapies have specific efficacy in reducing pain from tension-type headache (TTH).

Methods:   Computerized literature searches were performed. Papers were included if they described clinical (open noncontrolled studies) or randomized controlled trials in which any form of manual therapy was used for TTH, and if they were published after 1994 in the English language. Levels of scientific evidence, based on the quality and the outcomes of the studies, were established for each manual therapy: strong, moderate, limited, and inconclusive evidence.

Results:   Only 6 studies met the inclusion criteria. Analysis of the quality and the outcomes of all trials did not provide rigorous evidence that manual therapies have a positive effect in reducing pain from TTH.

Conclusions:   The authors found no rigorous evidence that manual therapies have a positive effect in the evolution of TTH. The most urgent need for further research is to establish the efficacy beyond placebo of the different manual therapies currently applied in patients with TTH.