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Osteopathic Manipulative Treatment for Headaches

Headaches are a very common ailment experienced by people of all ages and backgrounds. While occasional headaches may be manageable with over-the-counter pain relievers, chronic or severe headaches can significantly impact a person's quality of life, affecting their ability to work, socialize, and perform daily activities.

There are many different types of headaches—each with its own set of symptoms and triggers, and, thus, differing classes of causes—although the causes often remain unclear especially on a case-by-case basis. Traditional categories referred to as “tension”, “post traumatic”, and “cervicogenic” headaches are broadly understood to be caused by muscle and joint malfunction including malfunction associated with structural compromise such as disc/ligament damage and degenerative joint disease. These categories of headaches may be understood as primarily “biomechanical” in origin. Emotional factors and sinus congestion (aka “sinus headache”) are also common causes of muscle and joint malfunction.

There are two broad types of “migraine”:

a. Extremely severe pain without associated symptoms

b. Severe pain with other symptoms such as nausea, visual aberrations, and high sensitivity to light and/or noise

“Cluster” and “migraine” are episodic and understood to be due, at least in part, to malfunction of the autonomic nervous system. Migraines may be triggered by factors such as hormonal changes, food sensitivities, or environmental stimuli. However, there is also considerable evidence that muscle tension also plays an important role in migraine.

Osteopathic Approach to Headache Treatment

While conventional drug treatments provide relief for some individuals, there are alternative approaches that offer lower risk and more enduring solutions. Osteopathic treatment for headaches, rooted in the principles of osteopathic medicine, offers a unique and comprehensive approach to addressing the underlying causes of headache pain and promoting overall health and well-being.

The Osteopathic Difference

Osteopathic physicians, also known as a Doctors of Osteopathy (DO), and allopathic physicians, also known as Doctors of Medicine (MD), are both fully licensed physicians trained to diagnose, treat, and prevent illnesses / injuries. Both professions provide the full spectrum of medical and surgical services. However, there are important differences between the two professions:

1. Philosophy of Healthcare

Osteopathic physicians (DOs) learn a philosophy of healthcare that emphasizes the body's innate ability to heal itself as well as the interrelationships between the body's organ systems, uniquely appreciating the role of how musculoskeletal system malfunction may affect other organ systems as well as whole body function.

2. Osteopathic Manipulative Medicine (OMM)

Evaluation and treatment of musculoskeletal malfunction in the context of the Osteopathic Philosophy is known as Osteopathic Manipulative Medicine (OMM). Since its’ inception the Osteopathic profession has emphasized the importance of restoring optimal movement, not merely “alignment” of the body. A recent major advance in understanding impaired movement is found in A Treatise on the Functional Pathology of the Musculoskeletal System.

Additionally, as detailed in another blog, osteopathic physicians recognize that the cranium/face is a mobile structure. Malfunction of the joints and ligaments of the cranium may also play a pivotal role in not only headache but also in “entrapment neuropathies” of the cranium. Cranial malfunction may perpetuate malfunction of the neck, indeed throughout the body, through the reflex and connective tissue integrations that make the musculoskeletal structures an integrated organ system.

The techniques employed to treat musculoskeletal malfunction are known as Osteopathic Manipulative Treatment (OMT). Before performing OMT, osteopathic physicians conduct a thorough evaluation of the patient's medical history, symptoms, and physical examination findings —including the cranium—to determine the most appropriate techniques to use. OMT sessions typically last between 15 and 45 minutes, depending on the complexity of the condition being treated and the specific techniques being employed.

3. Osteopathic Manipulative Treatment (OMT)

Central to osteopathic treatment for headaches is Osteopathic Manipulative Treatment (OMT). OMT is a hands-on approach to diagnosing, treating, and preventing a wide range of health issues by restoring optimal potential movement to the entire body including the fluids within the central nervous system (cerebrospinal fluid and glymphatic fluid), thus improving nutrition and waste removal.

OMT encompasses a variety of techniques that osteopathic physicians use to optimize potential motion (aka “functional biomechanics”). Amongst others, those techniques include “soft tissue”, “articulation”, “post isometric relaxation stretching” (aka “muscle energy”), “myofascial release”, “counterstrain” and “thrust”. Restoring optimal potential motion promotes relaxation, improves circulation, and enhances mobility including respiration.

4. Comprehensive Assessment and Individualized Care

In addition to hands-on techniques, osteopathic treatment for headaches may also involve addressing underlying factors and triggers that contribute to pain and reduced activity. In addition to considering classical triggers, as fully trained physicians, DOs also provide care for concurrent diseases and/or conditions that help perpetuate musculoskeletal malfunction. Palpatory diagnosis and/or the response to OMT may also help identify otherwise hidden diseases and other co-factors such as habitual poor posture/ergonomics, nutritional deficiencies, stress, and other emotional factors that may exacerbate pain symptoms. DOs develop personalized treatment plans to address these underlying issues, seeking to empower patients to take an active role in their healing process and make positive lifestyle changes that promote long-term pain relief and wellness. Through education, guidance, and support, DOs help patients develop self-care strategies, coping mechanisms, and resilience to manage pain more effectively and improve their overall quality of life.


Osteopathic treatment offers a unique, holistic, and integrative approach to headache treatment that can benefit patients of all ages and backgrounds by reducing or eliminating the frequency, intensity, and duration of symptoms. With its emphasis on addressing the underlying causes of musculoskeletal dysfunction—including that of the cranium and face, rather than just treating symptoms, OMM provides lower risk and potentially enduring relief of headache and associated symptoms. Whether you suffer from occasional tension headaches or chronic migraines, consider exploring osteopathic treatment options to find personalized solutions that address your unique needs and promote lasting wellness.

 William James Brooks DO

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