title: Osteopathy for primary headache patients: a systematic review.
abstract: OBJECTIVE
  This systematic review aimed to assess the efficacy, effectiveness, safety, and tolerability of osteopathic manipulative treatment (OMT) in patients with headache.
  
  
  BACKGROUND
  Migraine is one of the most common and disabling medical conditions. It affects more than 15% of the general population, causing high global socioeconomic costs, and the currently available treatment options are inadequate.
  
  
  METHODS
  We systematically reviewed all available studies investigating the use of OMT in patients with migraine and other forms of headache.
  
  
  RESULTS
  The search of literature produced six studies, five of which were eligible for review. The reviewed papers collectively support the notion that patients with migraine can benefit from OMT. OMT could most likely reduce the number of episodes per month as well as drug use. None of the included studies, however, was classified as low risk of bias according to the Cochrane Collaboration's tool for assessing risk of bias.
  
  
  CONCLUSIONS
  The results from this systematic review show a preliminary low level of evidence that OMT is effective in the management of headache. However, studies with more rigorous designs and methodology are needed to strengthen this evidence. Moreover, this review suggests that new manual interventions for the treatment of acute migraine are available and developing.
authors.affiliation: Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration; Department of Neuroscience, Imaging and Clinical Sciences; ITAB - Institute for Advanced Biomedical Technologies, G. D'Annunzio University of Chieti, Pescara.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cerritelli
authors.affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Lacorte
authors.affiliation: Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration.
authors.forename: Nuria
authors.initials: N
authors.lastname: Ruffini
authors.affiliation: National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
keywords: disability; migraine; osteopathic manipulative treatment; pain; tension type headache