How do headache-specialised physiotherapists treat patients with migraine, tension-type, cervicogenic or temporomandibular-associated headaches – an online survey of the IHS Physiotherapy Special Interest Group

Background Headaches are commonly treated by physiotherapists, despite differing clinical recommendations and a lack of international guidelines to support consistent practice. Objective To provide an overview of treatment approaches used internationally by physiotherapists for patients with migraine, tension-type headache (TTH), cervicogenic headache (CgH) and headache attributed to temporomandibular disorders (TMD) to support the development of a minimum curriculum as part of the objectives of the Physiotherapy Special Interest Group (SIG) of the International Headache Society (IHS). Methods A cross-sectional online English language survey was developed and included questions on demographics treatment approaches for four headache types, and referral practices. Physiotherapists treating headache patients were recruited through the IHS Physiotherapy SIG network. Results Of 116 respondents, 76 physiotherapists completed all mandatory questions. Participants were trained in 26 countries and practiced in 24 countries across six continents. Migraine and TTH were the most frequently treated headache types, followed by CgH and TMD-related headache. Regardless of headache type, education, manual therapy, and exercise were commonly used. There was less use of body–mind approaches, electrotherapy and invasive techniques. Self-referral was the most common pathway into physiotherapy. Conclusion Physiotherapists with a special interest in headache worldwide treat a variety of headaches using, most frequently, education, manual therapy, and exercise. These findings support the need for an international curriculum to cover this spectrum of headaches and support the need for future guideline development for physiotherapy in headache care.