Listed in Issue 140


VAN ETTEKOVEN and LUCAS, Centre for Physiotherapy and Manual Therapy, Amstelveen, the Netherlands, have conducted a trial of physiotherapy for tension headache.


The aim of the study was to determine the effectiveness of a craniocervical training programme combined with physiotherapy for tension-type headache.


In a multicentre, randomized controlled trial with blinded outcome assessment, 81participants meeting the diagnostic criteria for tension-type headache were randomly assigned to an exercise group (physiotherapy and an additional craniocervical training programme) and a control group (physiotherapy alone). The treatment period was 6 weeks with follow-up assessment immediately thereafter and after 6 months. The primary outcome measure was headache frequency. Secondary outcomes included headache intensity and duration, Quality of Life (SF-36) and the Multidimensional Headache Locus of Control scale (MHLC).


At 6 months’ follow-up, the craniocervical training group showed significantly reduced headache frequency, intensity and duration (p < 0.001 for all). Effect sizes were large and clinically relevant. Loss to follow-up amounted to 3.7%.


Physiotherapy including craniocervical training reduces symptoms of tension-type headache significantly over a prolonged time frame.


van Ettekoven H, Lucas C. Efficacy of physiotherapy including a craniocervical training programme for tension-type headache; a randomized clinical trial. Cephalalgia 26 (8): 983-991, Aug 2006.

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