Skip navigation

Physiotherapy and manipulation for tension headache

Clinical bottom line

There is no evidence that physiotherapy or manipulation is of any value for tension headache.


Tension headache is probably the most common headache, without an underlying organic disease process. Such headaches can be short, or last several days. Most people will have tension headache at some time in their lives. Treatment is symptomatic, with physiotherapy and manipulation among the treatment choices.

Systematic review

The review was part of a much larger review for tension headache therapies, with searching to January 2003. Studies had to be randomised, conducted on adults with tension headache, with sensible diagnosis of tension headache. Spinal manipulation or physiotherapy had to be used, with at least one patient rated measure.


MB Lenssinck et al. The effectiveness of physiotherapy and manipulation in patients with tension-type headache: a systematic review. Pain 2004 112: 381-388.


There were two higher quality studies, with no significant difference between intervention and controls likely themselves to be ineffective, like low power laser light.


No evidence of any benefit.