Economic value of physiotherapy interventions in headache management: a scoping review

Abstract

BackgroundHeadache disorders impose a substantial economic burden. Health economic evaluations are vital for informing healthcare decisions by assessing the costs and benefits of interventions, including physiotherapy. Evaluating the cost-benefit impact of integrating physiotherapy into headache management is therefore essential.ObjectiveTo map studies including economic evaluations of physiotherapy interventions for headache management, defined as systematic comparisons of alternative treatments in terms of costs and outcomes.MethodsScoping review (PCC framework) conducted in PubMed, Embase, Web of Science, Scopus, INHTA databases (April 2026). Adults with headache receiving physiotherapy were included. Economic evaluations and cost measures were extracted. Studies were screened in two stages and synthesised descriptively. Reviews, trials, cohort, case report, case-control studies in English, Dutch, German were considered (Open Science Framework, https://doi.org/10.17605/OSF.IO/FVHXA).ResultsPhysiotherapy, as monodisciplinary, part of an interdisciplinary or multidisciplinary approach, was only included in eight out of 1271 studies. Interventions varied by setting (inpatient/outpatient) and delivery (individual/group). Three studies conducted cost-effectiveness analyses. A multimodal, interdisciplinary or multidisciplinary approach reduced medication-use, consultations, inpatient admissions (direct), and improved work status (indirect). However, evidence is insufficient to conclude that incorporating physiotherapy reduces healthcare costs.ConclusionA significant gap exists regarding the cost-reducing potential of physiotherapy in headache management. Rigorous economic analyses are needed to determine its clinical and economic value. Greater transparency and consensus on cost variables are recommended, along with investigation of which physiotherapy components yield optimal cost savings without compromising individual benefits.Clinical trial numberNot applicable.