OBJECTIVE: To evaluate the effects of a protocol involving soft tissue techniques and/or neural mobilization techniques in the management of patients with Frequent episodic tension-type headache (FETTH) and Chronic tension-type headache (CTTH). DESIGN: Randomized controlled, double blind, placebo control and before-after trial. SETTING: Rehabilitation area of Son Llatzer Hospital and Fisioplanet Centre. PARTICIPANTS: Ninety-seven patients (78 women; 19 men) diagnosed with FETTH or CTTH, were randomly assigned to groups A, B, C or D. INTERVENTIONS: (A) Placebo superficial massage; (B) soft tissue techniques; (C) neural mobilization; (D) a combination of (B) and (C). MAIN OUTCOMES MEASURES: The pressure pain threshold (PPT) in the temporal muscles (PPT1, PPT2) and supraorbital region (PPT3), the frequency (Freq) and maximal intensity (Int) of the pain crisis, and the punctuation using the Hit-6 questionnaire (Hit6) were evaluated. All variables were assessed before, at the end of the treatment and 15 days and 30 days post-intervention. RESULTS: Groups B, C, and D had an increase of PPT and a reduction of Freq, Int, and Hit-6 in all time-points after the intervention compared to baseline and group A (p < 0.001 in all cases). Group D had the highest PPT values and the lowest values in Freq and Hit-6 after the intervention. CONCLUSIONS: The application of soft tissue techniques and neural mobilization in FETTH or CTTH patients induces significant changes in pressure pain threshold, the characteristics of the pain crisis, and its impact on daily life activities compared to the application of these techniques as isolated interventions.

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