1. Introduction / Plain Theory

Headaches are among the most common health complaints worldwide, affecting people of all ages. Research estimates that almost half of the global adult population experiences a headache at least once a year, and for some, headaches become a frequent or chronic issue.

There are many different types of headaches, the most common being:

• Tension-type headaches (often described as a band-like pressure around the head).

• Migraines (intense, throbbing pain, sometimes with nausea, sensitivity to light, or visual disturbances).

• Cervicogenic headaches (head pain referred from the neck or upper spine).

Headaches can range from mild discomfort to debilitating pain that affects daily life, work, and social activities.

2. Typical Symptoms and Functional Impact

• Dull, pressing, or throbbing pain in the head, temples, or behind the eyes.

• Neck or shoulder tension often accompanying the pain.

• Difficulty concentrating, fatigue, or irritability.

• In the case of migraines: nausea, visual disturbances (“aura”), and heightened sensitivity to light or sound.

Red flags — headaches can sometimes be a symptom of serious conditions. Urgent medical evaluation is recommended if the pain:

• Starts suddenly and severely (“thunderclap headache”).

• Occurs after head injury.

• Is accompanied by fever, neurological symptoms (confusion, weakness, vision loss), or stiff neck.

3. Contributing Factors / Underlying Causes

Headaches often have multiple contributing factors, including:

• Musculoskeletal strain — tension in neck, shoulders, or jaw.

• Posture — prolonged sitting, screen time, or poor ergonomics.

• Stress — emotional and physical stress can increase muscle tension.

• Circulatory and neurological aspects — changes in blood vessels, nerves, or central sensitization.

• Lifestyle factors — lack of sleep, dehydration, diet, or caffeine intake.

4. Osteopathic Approach

Osteopaths consider headaches in the context of the whole body. An osteopathic consultation often includes:

• Detailed case history and physical examination to understand the type and possible origin of the headache.

• Assessment of the spine, neck, jaw, and posture, as well as circulation and breathing mechanics.

• Gentle manual techniques aimed at reducing muscle and joint tension, improving mobility, and supporting the body’s self-regulating processes.

Osteopathic treatment does not aim to “cure” all headaches, but rather to identify and address contributing factors that may ease symptoms and improve overall well-being.

5. Scientific Evidence & References

Recent reviews and meta-analyses indicate that manual and osteopathic therapies can yield modest to moderate benefits in reducing the frequency, intensity, and disability of certain headache types—particularly tension-type and cervicogenic headaches (e.g. Bini et al. 2022; Chaibi & Russell 2014). ScienceDirect+3BioMed Central+3BioMed Central+3 However, many existing clinical trials have methodological limitations (small sample sizes, high risk of bias, varied techniques), so the evidence should be interpreted with caution. PMC+2PMC+2 Some network meta-analyses suggest spinal manipulation may rank highest for pain improvement in cervicogenic headache compared to mobilization or massage. Frontiers In migraine contexts, selected trials show that adding osteopathic manipulation to standard care improved headache impact scores (e.g. Teubert et al. 2020) Lippincott Journals. Future large-scale, methodologically rigorous trials are needed to better delineate effectiveness, optimal protocols, and patient predictors of good response.

References

• Steiner TJ, Stovner LJ, Jensen R, Uluduz D, Katsarava Z. Headache disorders are third cause of disability worldwide. J Headache Pain. 2020;21(1):137. Link

• Cerritelli F, Lacorte E, Ruffini N, Vanacore N. Osteopathy for primary headache patients: a systematic review. J Pain Res. 2017;10:601-611. Link

• Bini F, Russo S, Cardinale A, et al. The effectiveness of manual and exercise therapy on cervicogenic headache: a systematic review and meta-analysis. Chiropr Man Therap. 2022;30(1):57. Link

• Herranz-Gómez A, Pérez-Bernal J, Plaza-Manzano G, et al. Effectiveness of exercise and manual therapy as treatment for patients with migraine, tension-type headache or cervicogenic headache: umbrella and mapping review with meta-meta-analysis. Appl Sci. 2021;11(15):6856. Link

• Chaibi A, Russell MB. Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials. J Headache Pain. 2014;15:67. Link

• Teubert G, Gerges C, Goodrich DE. Is osteopathic manipulative therapy as effective as medications for the treatment of headaches? Evidence-Based Practice. 2020;23(4):E12-E13. Link

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• Xie Y, Chen Z, Yang Z, et al. Comparative safety and efficacy of manual therapy interventions for cervicogenic headache: a network meta-analysis of randomized controlled trials. Front Neurol. 2025;16:1566764. Link