Osteopathy and Headaches: Between Science and Beliefs
Headaches (cephalalgia) affect nearly half of the world's population every year. While osteopathy is a common choice for relief, its actual effectiveness depends entirely on the cause of the headache. It is essential to distinguish between validated clinical approaches and speculative theories.
A cervicogenic headache is a "secondary" headache: the pain is felt in the head, but the actual source is located in the neck. This is the area where osteopathy has the strongest scientific backing.
Science explains this phenomenon through trigemino-cervical convergence. The nerves originating from the first three cervical vertebrae (C1, C2, C3) meet the same neurons as the trigeminal nerve (which manages facial sensation) in the brainstem.
The Consequence: The brain becomes "confused" and interprets a blockage or pain in the neck as pain located behind the eye, on the temple, or across the forehead.
Proven Efficacy: Meta-analyses (notably Jull et al. and Racicki et al.) confirm that cervical manipulations and mobilizations significantly reduce the frequency and intensity of these headaches.
Physical Action: Manual treatment helps restore mobility to the C0-C1 and C1-C2 joints, thereby reducing nerve irritation at the source.
Several concepts taught in traditional osteopathy lack a solid biological or physical foundation.
The Belief: Tension in the liver or stomach travels up to the skull via the fascia to cause migraines.
The Reality: There is no scientific evidence that manual manipulation of an organ can treat a headache. While neurological links (like the phrenic or vagus nerves) are real, the claim that massaging an organ "cures" a headache remains speculative.
The Myth: A shorter leg or a "twisted" pelvis creates a compensation chain up to the neck, triggering headaches.
The Reality: Asymmetry is the human norm. No study has established a solid correlation between minor postural asymmetry and the frequency of migraines. Claiming to "realign" the skeleton to treat the skull is an oversimplification.
The Belief: One can change the tension of the meninges or the pressure of the brain by manipulating skull bones.
The Critical Reality: Adult skull bones are fused. It is physically impossible to change their position through manual touch. The soothing effect comes from deep relaxation (reducing stress), which lowers pain perception but does not act mechanically on the bones.
Osteopathy does not "cure" migraines (which are neurovascular), but it is a valuable ally in treating the cervical component that often worsens the condition. A thorough medical examination (by a Neurologist or ENT) should always precede any osteopathic session to rule out serious underlying causes.