The effectiveness of manual therapy in individuals with headaches, with and without cervical degeneration: analysis of six cases

Background: Tension-type headaches (TTH) are generally treated with prophylactic medication. With regard to Physical Therapy treatment, many types of procedures have been reported, ranging from electrotherapy and acupuncture to techniques such as cervical traction, vertebral mobilization, stretching and relaxation. Objective: To examine the evolution of six patients diagnosed with TTH who underwent a Physical Therapy treatment protocol consisting of manual therapy. Method: Six individuals were followed up (three with associated vertebral abnormalities and three with no abnormalities). Five participants were women and one was a man. They underwent treatment consisting of ten sessions of manual cervical traction, stretching, vertebral mobilization and massage. Pain intensity was assessed using a visual analog scale (VAS) and the pain threshold for pressure on the upper trapezius muscle was measured using an analog pressure algometer (PDT; pain detection threshold). The data were graphically displayed in a multiple baseline system and during a follow-up period. Results: Even though this treatment showed positive results in all cases, in relation to pain intensity, greater difficulty in completely relieving the symptoms was found among the individuals who did not have vertebral abnormalities. With regard to PDT, it was found that individuals with cervical degeneration presented greater improvement.