Osteopathic Manipulative Treatment

An unconventional treatment with potential for headache relief?

Osteopathic manipulative treatment (OMT) combines a variety of manual techniques to assess and treat illness or injury (Baltazar et al., 2020). It typically involves movement of muscles, joints and ligaments through stretching, gentle pressure and resistance (Baltazar et al., 2020). For cranial treatment, light manual force is applied predominately to the head with the goal of aiding pain, vision, autonomic regulation and sleep (Baltazar et al., 2020). There are four principles of osteopathy as defined by the American Association of Colleges of Osteopathic Medicine:  

1) The body is a unit; the person is a unit of body, mind, and spirit 2) The body is capable of self-regulation, self-healing, and health maintenance 3) Structure and function are reciprocallyinterrelated 4) Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function (p. 1).    

The benefits and limitations of OMT for headache treatment was highlighted in a recent literature review (Whalen et al., 2018). Seven studies were examined; all of which used OMT or a combination of OMT with conventional methods to treat various headache types (Whalen et al., 2018). These types included sinus congestion/sinus infection, tension headaches, migraines, dental-related headaches, post-traumatic headaches and headaches from concussions (Whalen et al., 2018). A positive outcome was observed in all headache types, with decreased symptom scores, as well as frequency and headache prevention in certain studies (Whalen et al., 2018). Each treatment protocol was different, as decided by the osteopathic physician after the initial assessment. Even in treating the same headache condition, the techniques varied in time and the type of OMT that was completed (Whalen et al., 2018).    

OMT is used to treat headaches through a variation of techniques; all of which focus on improving somatic dysfunctions regarding the head or neck (Whalen et al., 2018). Somatic dysfunctions are an osteopathic term defined as impaired and/or altered function of the structures that make up the body’s framework (Whalen et al., 2018). This includes the skeletal, arthrodial, myofascial systems and pertinent vascular, lymphatic and neural components (Whalen et al., 2018). By treating these dysfunctions, headaches caused by myofascial and structural restrictions in the head and neck are able to be attended to (Whalenet al., 2018).    

OMT has potential to be a promising headache treatment method for those who are unable or disprefer more conventional therapies (Whalen et al., 2018). However, there are also a number of limitations with OMT which include its lack of publications and standardization with both treatment procedures and measures (Whalen et al., 2018). The majority of peer reviewed literature examined was case studies, therefore more higher level evidence is needed to determine its efficacy (Whalen et al., 2018). The benefits of OMT, would be better seen with studies that eliminate other forms of therapies and state in detail all variables surrounding treatment: technique description, time, frequency, etc. (Whalen et al., 2018).   


American Association of Colleges of Osteopathic Medicine. (n.d.). The Philosophy of Osteopathic Medicine. https://www.aacom.org/become-a-doctor/about-osteopathic medicine/philosophy-tenets-of-osteopathic-medicine   

Baltazar, G. A., Kolwitz, C., Petrone, P., Stright, A., & Joseph, D. (2020). Osteopathic Manipulative Treatment Relieves Post-concussion Symptoms in a Case of Polytrauma. Cureus, 12(3), e7317. https://doi.org/10.7759/cureus.7317   

Whalen, J., Yao, S., & Leder, A. (2018). A short review of the treatment of headaches using osteopathic manipulative treatment. Current Pain and Headache Reports, 22(12), 1-7. https://doi.org/10.1007/s11916-018-0736-y