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Case Reports
. 2020 Dec 12;12(12):e12040.
doi: 10.7759/cureus.12040.

Osteopathic Manipulative Treatment in Tension Headaches

Justin Chin  1   2 , Wenqi Qiu  3 , Christine M Lomiguen  4 , Mikhail Volokitin  5
Affiliations
Case Reports

Osteopathic Manipulative Treatment in Tension Headaches

Justin Chin et al. Cureus. .

Abstract

Tension-type headaches, associated with young age, poor health, sleep disturbances, anxiety, stress, and poor posture, account for 90% of all headaches diagnosed by healthcare professionals. Diagnosis and treatment of the various headache subtypes are often aimed at determining the underlying cause but commonly involve over-the-counter pain medication. Because recurrence is common in tension-type headaches, with a subsequent refractory response to over-the-counter medications, adjunctive and alternative treatment modalities should be further studied. Here we present a case of tension headache initially non-responsive to pain medication but resolved with osteopathic manipulative treatment and lifestyle modifications. Osteopathic considerations and literature are also reviewed in the broader context of headache management.

Keywords: headache; muscle energy; nsaid; omm; osteopathic care; osteopathic manipulative medicine; pain control; suboccipital; tension; tension headache.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Complete osteopathic structural exam
Adapted from the Journal of the American Osteopathic Association, with patient findings [6,7]. TART: tenderness, asymmetry, restricted motion, tissue texture changes.
Figure 2
Figure 2. 2A reveals common hand placement for myofascial release of the cervical muscles, in which upward tractional force (red arrow) is applied to the cervical paraspinal muscles. 2B shows a variation of muscle energy with hand placement and force vectors (red arrows) for the cervical region.
Figure 3
Figure 3. Direct inhibition of the trapezius muscles with hand placement denoted with red circles. This treatment can decrease the tone of hypertonic muscles that contribute to tension headaches.
Figure 4
Figure 4. 4A: Suboccipital stretch with hand placement at the suboccipital groove and force vectors (red arrow). B. Active resistance and force of the patient engagement cervical muscles toward the ground (red arrow).
Figure 5
Figure 5. Suboccipital region with illustration inset of associated muscles and nerves in the area. (Original illustration created by YaQun Zhou)
See this image and copyright information in PMC

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