The possibility of using osteopathic correction in combination with psychotherapeutic techniques in the treatment of tension headaches

This article describes a case of successful combined treatment of chronic tension headache (CTH) in a 40-year-old female patient using osteopathic and psychotherapeutic correction. After experiencing a psychotraumatic situation (divorce), the patient first experienced episodes of headache that met the criteria for frequent episodic TTH according to the International Classification of Headache Disorders (ICHD-3). Over several months, there was a gradual increase in the frequency of attacks to 20 days per month with an intensity of 6–7 points on the VAS, which indicated the progression of the disease and allowed for the diagnosis of chronic TTH. An osteopathic examination revealed a number of somatic dysfunctions (SD), including global psychovisceral SD and regional SD in the head, neck, chest, pelvis, and dura mater. Given the incomplete relief of symptoms with pharmacotherapy and the pronounced affective background, non-drug treatment was performed, including osteopathic correction and cognitive-behavioral therapy. After two osteopathic and one psychotherapeutic sessions, significant improvement was noted: the frequency of headaches decreased to 1–2 episodes per month, global and regional SD regressed, the level of depression on the Beck scale decreased from 28 to 10 points, anxiety on the Spielberger scale decreased from 48 to 8 points for situational anxiety and from 46 to 10 points for personal anxiety. The results demonstrate the potential of a comprehensive non-pharmacological approach combining osteopathic correction and psychotherapy. The use of osteopathy as part of individualized therapy is consistent with the provisions of the current clinical guidelines for the treatment of tension headaches from the Russian Ministry of Health (2025), which emphasize the validity of including manual and psychotherapeutic methods in the presence of pronounced muscle-tonic and affective components characteristic of chronic tension headaches.