Anesthesiology and Pain Medicine

Published by: Kowsar

Multimodal Physiotherapy Based on a Biobehavioral Approach as a Treatment for Chronic Tension-Type Headache: A Case Report

Hector Beltran-Alacreu 1 , 2 , 3 , Ibai Lopez-de-Uralde-Villanueva 1 , 2 , 3 , 4 and Roy La Touche 1 , 2 , 3 , 4 , *
Authors Information
1 Department of Physiotherapy, Faculty of Health Science, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
2 Research Group on Movement and Behavioural Science and Study of Pain, The Center for Advanced Studies University La Salle, Autonomous University of Madrid, Madrid, Spain
3 Institute of Neuroscience and Craniofacial Pain (INDCRAN), Madrid, Spain
4 La Paz Hospital Institute for Health Research, IdiPAZ, Madrid, Spain
Article information
  • Anesthesiology and Pain Medicine: December 01, 2015, 5 (6); e32697
  • Published Online: December 13, 2015
  • Article Type: Case Report
  • Received: August 27, 2015
  • Revised: September 20, 2015
  • Accepted: October 11, 2015
  • DOI: 10.5812/aapm.32697

To Cite: Beltran-Alacreu H, Lopez-de-Uralde-Villanueva I, La Touche R. Multimodal Physiotherapy Based on a Biobehavioral Approach as a Treatment for Chronic Tension-Type Headache: A Case Report, Anesth Pain Med. 2015 ; 5(6):e32697. doi: 10.5812/aapm.32697.

Copyright © 2015, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Introduction
2. Case Presentation
3. Discussion
  • 1. Stovner L, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007; 27(3): 193-210[DOI][PubMed]
  • 2. Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J, et al. EFNS guideline on the treatment of tension-type headache - report of an EFNS task force. Eur J Neurol. 2010; 17(11): 1318-25[DOI][PubMed]
  • 3. Headache Classification Committee of the International Headache S. The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013; 33(9): 629-808[DOI][PubMed]
  • 4. Stillman MJ. Pharmacotherapy of tension-type headaches. Curr Pain Headache Rep. 2002; 6(5): 408-13[PubMed]
  • 5. Monteith TS, Oshinsky ML. Tension-type headache with medication overuse: pathophysiology and clinical implications. Curr Pain Headache Rep. 2009; 13(6): 463-9[PubMed]
  • 6. Haag G. Letter to the editor concerning Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J. EFNS guideline on the treatment of tension-type headache--report of an EFNS task force. Eur J Neurol 2010; 17: 1318-1325. Eur J Neurol. 2011; 18(7)-2[DOI][PubMed]
  • 7. Gil-Martinez A, Kindelan-Calvo P, Agudo-Carmona D, Munoz-Plata R, Lopez-de-Uralde-Villanueva I, La Touche R. [Therapeutic exercise as treatment for migraine and tension-type headaches: a systematic review of randomised clinical trials]. Rev Neurol. 2013; 57(10): 433-43[PubMed]
  • 8. Lozano Lopez C, Mesa Jimenez J, de la Hoz Aizpurua JL, Pareja Grande J, Fernandez de Las Penas C. Efficacy of manual therapy in the treatment of tension-type headache. A systematic review from 2000-2013. Neurologia. 2014; [DOI][PubMed]
  • 9. Wieser T, Walliser U, Womastek I, Kress HG. Dysfunctional coping in headache: avoidance and endurance is not associated with chronic forms of headache. Eur J Pain. 2012; 16(2): 268-77[DOI][PubMed]
  • 10. Carlson CR. Psychological considerations for chronic orofacial pain. Oral Maxillofac Surg Clin North Am. 2008; 20(2): 185-95[DOI][PubMed]
  • 11. Turk DC. Cognitive-behavioral approach to the treatment of chronic pain patients. Reg Anesth Pain Med. 2003; 28(6): 573-9[PubMed]
  • 12. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001; 8(12): 1153-7[PubMed]
  • 13. Bjorner JB, Kosinski M, Ware Jr JE. Calibration of an item pool for assessing the burden of headaches: an application of item response theory to the headache impact test (HIT). Qual Life Res. 2003; 12(8): 913-33[PubMed]
  • 14. Gandek B, Alacoque J, Uzun V, Andrew-Hobbs M, Davis K. Translating the Short-Form Headache Impact Test (HIT-6) in 27 countries: methodological and conceptual issues. Qual Life Res. 2003; 12(8): 975-9[PubMed]
  • 15. Garcia Campayo J, Rodero B, Alda M, Sobradiel N, Montero J, Moreno S. [Validation of the Spanish version of the Pain Catastrophizing Scale in fibromyalgia]. Med Clin (Barc). 2008; 131(13): 487-92[PubMed]
  • 16. Andrade Ortega JA, Delgado Martinez AD, Almecija Ruiz R. Validation of the Spanish version of the Neck Disability Index. Spine (Phila Pa 1976). 2010; 35(4)-8[DOI][PubMed]
  • 17. Harris KD, Heer DM, Roy TC, Santos DM, Whitman JM, Wainner RS. Reliability of a measurement of neck flexor muscle endurance. Phys Ther. 2005; 85(12): 1349-55[PubMed]
  • 18. Gross A, Miller J, D'Sylva J, Burnie SJ, Goldsmith CH, Graham N, et al. Manipulation or mobilisation for neck pain: a Cochrane Review. Man Ther. 2010; 15(4): 315-33[DOI][PubMed]
  • 19. Leaver AM, Refshauge KM, Maher CG, McAuley JH. Conservative interventions provide short-term relief for non-specific neck pain: a systematic review. J Physiother. 2010; 56(2): 73-85[PubMed]
  • 20. Masaracchio M, Cleland JA, Hellman M, Hagins M. Short-term combined effects of thoracic spine thrust manipulation and cervical spine nonthrust manipulation in individuals with mechanical neck pain: a randomized clinical trial. J Orthop Sports Phys Ther. 2013; 43(3): 118-27[DOI][PubMed]
  • 21. Hanney WJ, Kolber MJ, Cleland JA. Motor control exercise for persistent nonspecific neck pain. Phys Ther Rev. 2010; 15(2): 84-91
  • 22. Kindelan-Calvo P, Gil-Martinez A, Paris-Alemany A, Pardo-Montero J, Munoz-Garcia D, Angulo-Diaz-Parreno S, et al. Effectiveness of therapeutic patient education for adults with migraine. A systematic review and meta-analysis of randomized controlled trials. Pain Med. 2014; 15(9): 1619-36[DOI][PubMed]
  • 23. Verhagen AP, Damen L, Berger MY, Passchier J, Koes BW. Behavioral treatments of chronic tension-type headache in adults: are they beneficial? CNS Neurosci Ther. 2009; 15(2): 183-205[PubMed]
  • 24. Soderlund A, Lindberg P. An integrated physiotherapy/cognitive-behavioural approach to the analysis and treatment of chronic whiplash associated disorders, WAD. Disabil Rehabil. 2001; 23(10): 436-47[PubMed]
  • 25. Engquist M, Lofgren H, Oberg B, Holtz A, Peolsson A, Soderlund A, et al. Surgery versus nonsurgical treatment of cervical radiculopathy: a prospective, randomized study comparing surgery plus physiotherapy with physiotherapy alone with a 2-year follow-up. Spine (Phila Pa 1976). 2013; 38(20): 1715-22[DOI][PubMed]
  • 26. Vibe Fersum K, O'Sullivan P, Skouen JS, Smith A, Kvale A. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur J Pain. 2013; 17(6): 916-28[DOI][PubMed]
  • 27. MacDermid JC, Walton DM, Avery S, Blanchard A, Etruw E, McAlpine C, et al. Measurement properties of the neck disability index: a systematic review. J Orthop Sports Phys Ther. 2009; 39(5): 400-17[DOI][PubMed]
  • 28. Turner JA, Aaron LA. Pain-related catastrophizing: what is it? Clin J Pain. 2001; 17(1): 65-71[PubMed]
  • 29. Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001; 17(1): 52-64[PubMed]
  • 30. Nijs J, Van de Putte K, Louckx F, Truijen S, De Meirleir K. Exercise performance and chronic pain in chronic fatigue syndrome: the role of pain catastrophizing. Pain Med. 2008; 9(8): 1164-72[PubMed]
  • 31. Nijs J, Meeus M, Heins M, Knoop H, Moorkens G, Bleijenberg G. Kinesiophobia, catastrophizing and anticipated symptoms before stair climbing in chronic fatigue syndrome: an experimental study. Disabil Rehabil. 2012; 34(15): 1299-305[DOI][PubMed]
  • 32. Meeus M, Nijs J, Van Mol E, Truijen S, De Meirleir K. Role of psychological aspects in both chronic pain and in daily functioning in chronic fatigue syndrome: a prospective longitudinal study. Clin Rheumatol. 2012; 31(6): 921-9[DOI][PubMed]
  • 33. Leeuw M, Goossens ME, Linton SJ, Crombez G, Boersma K, Vlaeyen JW. The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007; 30(1): 77-94[DOI][PubMed]
  • 34. Vlaeyen JW, Linton SJ. Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000; 85(3): 317-32[PubMed]
  • 35. Moseley GL, Nicholas MK, Hodges PW. A randomized controlled trial of intensive neurophysiology education in chronic low back pain. Clin J Pain. 2004; 20(5): 324-30[PubMed]
  • 36. Bird SB, Dickson EW. Clinically significant changes in pain along the visual analog scale. Ann Emerg Med. 2001; 38(6): 639-43[DOI][PubMed]
  • 37. Emshoff R, Emshoff I, Bertram S. Estimation of clinically important change for visual analog scales measuring chronic temporomandibular disorder pain. J Orofac Pain. 2010; 24(3): 262-9[PubMed]
  • 38. Castien R, Blankenstein A, van der Windt D, Heymans MW, Dekker J. The working mechanism of manual therapy in participants with chronic tension-type headache. J Orthop Sports Phys Ther. 2013; 43(10): 693-9[DOI][PubMed]
Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments