Headaches – Does manual therapy help?

At Total Balance, we are currently seeing a large number of clients with headaches. With our worlds turned upside down, stress and our working environments changing during these last two years you can understand why. Our main role is to define a) what type of headache it is and b) can we help. Clients often present to physiotherapists as a first point of call and right now our diagnosis skills could not be more important. 

There are three types of headaches we commonly see:

Tension headaches, migraine headaches and cervicogenic headaches are the most prevalent forms of headaches with significant socio-economic burdens. 

*On a side note: Migraines are more common in women, peak during the third decade of life and decline with age.

Once we identify the type of headache we will assess whether we can help or if the client needs to be referred on for further investigations and treatment. 

At our end treatment options include

  • Pharmacological treatment (this can come with side effects and other complications).
  • Manual therapy techniques 
  • Natural therapies including, diet and herbal remedies

In a systematic review by Falsiroli Maistrello, L., Rafanelli, M. & Turolla, A. they looked at Manual Therapy and Quality of Life in People with Headaches. The systematic review found all forms of manual therapy techniques appeared to be more favourable along with exercise and education for the treatment of headaches compared to medication and placebo treatment in patients with tension and migraine headaches. 

Manual therapy techniques administered in the studies included articular mobilization, myofascial trigger point treatment, suboccipital inhibitory pressure and manipulation of upper cervical segments, soft tissue techniques and neuro-dynamic techniques. Post-treatment follow-up periods ranged from two weeks to nine months. 

These are all techniques that we use at TB so next time you experience a headache make sure you reach out to discuss your options. 


Falsiroli Maistrello, L., Rafanelli, M. & Turolla, A. Manual Therapy and Quality of Life in People with Headache: Systematic Review and Meta-analysis of Randomized Controlled Trials. Curr Pain Headache Rep 23, 78 (2019)