The role of physiotherapy in headache treatment: literature review

Abstract

The intolerance to movements, neck disability and changes in pericranial muscles are aspects that can affect during migraine attacks. The presence of these findings allowed the physiotherapy to be an alternative therapeutic modality for the headache. Thus, the structural and behavioral disorders can promote muscle changes in the biomechanics of the head and neck, as well as limitations in the cervical mobility of patients with headache, which can be treated by different physiotherapy modalities. The aim of this study was to review the relevant publications on the role of physiotherapy in the treatment of headache, in order to support and direct the non-pharmacological treatment of these patients. A literature survey, between September/2015 and May/2016, was done on the basis of MEDLINE/PubMed, LILACS and Cochrane Central Register of Controlled Trials - CENTRAL, looking for randomized and quasi-randomized controlled trials on the subject. The MeSH/DeCS descriptors were: 'headache', 'physical therapy modalities,' and their equivalents in English. We identified 589 articles, of which 19 were included, according to the eligibility criteria. According to the evaluated studies results, physiotherapy promotes improvement of headache, associated symptoms and musculoskeletal disorders related. The modalities used are postural correction, spinal mobilization, muscle stretching, relaxation techniques, massage, active or passive exercises and others. Due to the low methodological quality of most of these studies, it is important to conduct new randomized controlled trials, based on the ICHD diagnostic criteria, using protocols described in more detail and reproducible way, including the assessment of adverse effects.