BACKGROUND: Cervicogenic (CGH) and tension-type (TTH) headaches are prevalent conditions that are associated with considerable pain and disability. Joint mobilization and manipulation are common interventions used by physical therapists to manage individuals with musculoskeletal conditions. However, there is controversy surrounding their effectiveness. OBJECTIVES: To evaluate the effectiveness of mobilization and manipulation (MM) compared to other conservative treatments on reducing pain, frequency, and disability in patients with CGH and TTH. METHODS: A literature search using terms related to mobilization, manipulation, CGH, and TTH was conducted to identify randomized clinical trials comparing MM to conservative treatment in treating CGH and TTH. The overall quality of the evidence was assessed using the Cochrane risk-of-bias tool. Meta-analysis and qualitative synthesis of the evidence were performed. RESULTS: Nine total studies were included in the systematic review. The majority of studies scored lower than a 69% on the Cochrane risk of bias tool indicating a moderate to high risk of bias. MM were found to be equally as effective as conservative treatment in reducing pain, disability, and frequency of headache in individuals with CGH. MM had statistically significant short-term (1 to 4 weeks) improvements over conservative treatment for TTH on pain and disability, but not frequency. When comparing the effectiveness of MM versus conservative treatment for TTH, both groups exhibited improvement between 1 to 3 months in all three outcomes. CONCLUSIONS: Manipulation and mobilization were only found to be more effective than conservative care at short-term follow up for individuals with TTH.

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