An exploration of possible future non-pharmacological multidisciplinary treatments to potentiate withdrawal strategy and recovery from medication overuse headache (MOH): a narrative review.

Marco Balordi, Nicholas Diani, Mattia Sinatra, Daniele Lovattini, Gianluca Rossetto, Antonio Morandi, Angelo Bellinvia, Matteo Castaldo, Alessandro Viganò

Journal: Journal of oral & facial pain and headache 2026;40(3):1-13

PMID: 42220284

Abstract

Medication Overuse Headache (MOH) is a secondary headache resulting from the sustained overuse of acute headache medications, and represents a clinical challenge for its complex pathophysiology and high relapse rate. This narrative review examines non-pharmacological strategies for the management of MOH, and explores the potential role of a multidisciplinary approach in improving patient outcomes. The available evidence on patient education, psychotherapy, behavioral interventions, physical therapy, and neuromodulation techniques was reviewed, along with other non-pharmacological approaches, such as dietary modifications, Ayurveda, and acupuncture. These interventions may help in targeting multiple dimensions of MOH pathophysiology, and could be tailored to individual patient needs. Integrating multimodal non-pharmacological interventions with medication withdrawal and, when appropriate, bridging therapies appears promising in improving outcomes and reducing the overall burden of MOH. However, further research is required to identify the optimal combination and duration of multidisciplinary interventions.

©2026 The Author(s). Published by MRE Press.

Address: Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy.; IRCCS Fondazione Don Gnocchi ETS, 20148 Milan, Italy.; Department of Biomedical and Clinical Sciences, University of Milan, 20122 Milan, Italy.; Healthcare Innovation Technology Lab, IRCCS San Camillo Hospital, 30126 Venice, Italy.; Ayurvedic Point, School of Ayurvedic Medicine, 20149 Milan, Italy.; Headache Centre, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.; Clinical Psychophysiology and Clinical Neuropsychology Labs, University of Parma, 43125 Parma, Italy.; Neurology Unit, Humanitas Gavazzeni Hospital, 24125 Bergamo, Italy.
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