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Headaches have been described as the most common medical complaint in society (Dalessia 1987:3), and Tension-type headaches constitute approximately 80% of these (Martin 1993:22). Although Episodic tension-type headache is more prevalent than Chronic tension-type headache and may have a greater societal impact, Chronic tension-type headache has by far a greater individual impact (Schwartz et aI, 1998) on the patient. The exact causes of Chronic tension-type headaches are not known and, as a result, treatment is commonly symptomatic in nature and aimed at reducing pain. To date, treatment commonly involves the use of drugs and with it comes the threat of drug-induced side-effects (Bendtsen et aI, 1996). The purpose of this study was to investigate two non-pharmacological treatments in the management of Chronic tension-type headaches, namely the relative effectiveness of Spinal Manipulative Therapy (SMT) in conjunction with Trans-cutaneous Electrical Nerve Stimulation (TENS), as compared with SMT and placebo TENS. ABSTRACT It was hypothesized that SMT in conjunction with TENS would provide a greater immediate and short-term benefit in comparison to SMT and placebo TENS in the treatment of mild

The effectiveness of spinal manipulative therapy and trans-cutaneous electrical nerve stimulation versus spinal manipulative therapy and placebo trans-cutaneous electrical nerve stimulation in the treatment of mild to moderate chronic tension-type headache