The effectiveness of physiotherapy for chronic headaches in patients with temporomandibular disorders: a systematic review.

The review included only five randomized trials and could not combine them in a meta-analysis because the interventions, headache diagnoses, outcomes, and participant groups differed. All included trials had some concerns for deviations from intended intervention because participants or personnel were not blinded, and all had some concerns for outcome measurement because blinding of outcome assessors at the end was not reported. One trial had concerns about allocation concealment. The search did not include Embase, Scopus, or Web of Science, and the protocol was not registered in PROSPERO. Follow-up periods were short and varied, from five weeks to six months. Two trials enrolled only women, so the evidence says little about men. Some trials did not describe the precise home exercises, manual therapy techniques, coordination exercises, desensitization, or neuromuscular treatments. Some treatments were delivered by clinicians other than physiotherapists or the therapist type was not specified. Control groups were not the same across studies; some received no intervention, some usual care, and some active treatment, making direct comparison difficult. Headache diagnoses varied; two studies used specific ICDH definitions and three did not specify headache type.

The authors declared no financial support for the research or publication.

Do not read this as proof that TMJ mobilization alone treats chronic headache. The trials used different multi-component packages, including neck treatment, jaw exercises, stretching, education, and home care, and one trial found no headache benefit, so the active component cannot be identified.