Integrating manual therapy into headache management bridging the evidence gap

Manual therapy remains an underutilized yet promising complementary intervention for headache management. Despite growing evidence supporting its efficacy, it is often overshadowed by pharmacological approaches and other non-pharmacological treatments such as acupuncture. This article highlights the potential role of manual therapy in reducing headache frequency and intensity, particularly in tension-type headaches and migraine. By addressing musculoskeletal dysfunctions and central sensitization, manual therapy can serve as a valuable component of multimodal care. Future research should focus on large-scale trials and cost-effectiveness analyses to strengthen the evidence base and promote its integration into clinical guidelines.