The effect of physiotherapy and acupuncture on psychocognitive, somatic, quality of life, and disability characteristics in TTH patients

George Georgoudis,1,2 Bledjana Felah,2 Pantelis T Nikolaidis,3 Maria Papandreou,1 Evanthia Mitsiokappa,4 Andreas F Mavrogenis,4 Thomas Rosemann,5 Beat Knechtle5,6 1Musculoskeletal and Respiratory Research Lab, Department of Physiotherapy, University of West Attica, Athens, Greece; 2PhysioPain Group, Pain Specialist & Rehabilitation Centers, Athens, Greece; 3Exercise Physiology Laboratory, Nikaia, Greece; 4First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece; 5Institute of Primary Care, University of Zurich, Zurich, Switzerland; 6Medbase St. Gallen Am Vadianplatz, St. Gallen, Switzerland Introduction: Nonpharmacological therapies have been widely used to treat tension-type headache (TTH); however, limited evidence exists with regards to their effectiveness. Therefore, the aim of the present study was to examine the combined effect of acupuncture, stretching, and physiotherapy (myofascial release techniques and microwave diathermy) on psychocognitive, somatic, quality of life, and disability characteristics in such patients. Subjects and methods: Patients with TTH (n=44) performed either acupuncture or stretching (control group, n=20) or acupuncture, stretching, and physiotherapy (experimental group, n=24) during a 4-week intervention period including 10 treatment sessions. They were tested for the Greek version of the Short-Form McGill Pain Questionnaire, the Greek version of the Migraine Disability Assessment Questionnaire, the Greek version of the Hospital Anxiety and Depression Scale, Short Form Health Survey 12 9 (SF-12), and Pain Catastrophizing Scale at baseline after the fifth and tenth sessions. Results: All measures were improved throughout the first to tenth session (P0.05). Conclusion: In summary, a significant beneficial role of acupuncture, stretching, and physiotherapy on cognitive, psychosomatic pain measures, disability index, quality of life, and catastrophizing in patients with TTH was observed. Keywords: tension-type headache, acupuncture, physiotherapy, stretching, psychocognitive characteristics, myofascial release