Technique in the osteopathic treatment of patients with tension-type headache atlanto-occipital joint manipulation and suboccipital inhibition

Introduction: The tension-type headache is extremely common, and has repercussions in both the work environment and the social life of the people who suffer from them. Objectives: To evaluate the efficiency of two manual therapy treatments in patients with tension-type headaches. Material and Methods: A random, double-blind trial was undertaken, with seventy-six (n=76) patients (81.6% women) diagnosed with tension-type headache (39.9 ± 10.9 years), distributed in four groups (n=19 each one), three experimental groups and one control group (without intervention). Interventions in experimental groups included osteopathic manual therapy with: 1) Suboccipital soft tissue Inhibition Technique (SIT); 2) Occiput-Atlas-Axis global manipulation (OAA); 3) The combination of both (SIT+OAA). Treatments were applied during four sessions (one per week), with follow-up at 30 days. Patients were evaluated before and after treatment and during follow-up, by monitoring cervical mobility, the impact of pain and the frequency and intensity of the headache. Results: The SIT group significantly improved the impact of the pain (p=0.02). The OAA group and the SIT+OAA group, improved the headache impact and intensity (p<0.001 to p=0.05), and suboccipital flexion and extension (p<0.001 to p=0.04). The OAA group also improved cervical rotations (p=0.008 to p=0.007). The SIT+OAA group obtained significant results in the frequency and intensity of the pain (p<0.001 to p=0.05). Conclusions: The three treatments applied were effective in the impact of headache and in pain intensity. The OAA treatment is the most effective in increasing cervical mobility, followed by the SIT treatment. The combined treatment SIT +OAA was the most effective in reducing the frequency and the intensity of the pain caused by tension-type headache(AU)