Potential Add-On Effects of Manual Therapy Techniques in Migraine Patients: A Randomised Controlled Trial

Abstract

Objective: To ascertain whether the combination of soft tissue and articulatory manual techniques is more effective than either one of these techniques alone for reducing migraine impact; Methods: Seventy-five participants with migraine were randomly divided into three groups (n = 25 per group): (i) soft tissue (STG), (ii) articulatory (AG), and (iii) combined treatment (STAG). Pain, frequency of occurrence, duration, disability and impact, depression and anxiety levels, and perception of change were analysed at baseline, post intervention (T2) and at four-week follow-up (T3); Results: STAG showed a significantly greater reduction in pain versus STG and AG at T2 (p < 0.001; p = 0.014) and at T3 (p < 0.001; p = 0.01). Furthermore, STAG achieved a significantly greater reduction in pain duration versus STG at T2 (p = 0.020) and T3 (p = 0.026) and a greater impression of change versus STG (p = 0.004) and AG (p = 0.037) at T3. Similar effects were observed in all groups for frequency of occurrence, migraine disability, impact, and depression and anxiety levels; Conclusions: A combined manual therapy protocol including soft tissue and articulatory techniques yields larger improvements on pain and perception of change than either technique alone, yet the three therapeutic approaches show similar benefits for reducing pain, disability and impact caused by the migraine, depression or anxiety levels.

Effects of Upper Cervical Spine Manual Therapy on Central Sensitization and Disability in Subjects with Migraine and Neck Pain

“…In other words, upper cervical MT may modulate nociceptive pathways by initiating a cascade of neurophysiological responses from the peripheral nervous system (modulation of inflammatory responses), and the central nervous system at spinal (activation of somato-autonomic reflexes) and supraspinal levels (regulation of brain areas such as anterior cingulate cortex, amygdala or periaqueductal grey) in subjects with migraine (26). There are many mechanoreceptors in the upper cervical region especially in the occipital region, which potentiate mechanical inputs from MT techniques, resulting in decreasing headache symptoms (50).…”

“…Mobilization of the upper cervical spine has a positive effect on the inhibitory systems in the spinal cord and can modulate nociception and decrease sensitization (20,21). Numerous studies show improvement in headache characteristics as well as disability following MT (22)(23)(24)(25)(26). Increasing function and reducing disability associated with migraine attacks are some of the main goals in the management of migraine (27).…”

Primary headache management in a multidisciplinary team – a pilot study

“…They work best in the cases of tension-type headaches [ 37 ]. On the other hand, manual therapy helps with migraines that worsen because of associated stiff muscles and joints, but they are mostly compensatory measures, relieving the muscular adaptations that increase pain [ 38 , 39 ]. Even so, it is a risk-free approach and may be worth considering as a treatment option.…”

Tuina on knee pain and physical function for patients with mild-moderate knee osteoarthritis in Shanghai: protocol for a multicenter, assessor-blinded, randomized controlled trial

“…Tuina, a form of non-invasive physical therapy, is based on the meridians theory of Traditional Chinese Medicine (TCM) uses appropriate manipulation by evaluating speci c symptoms to treat different diseases. The e cacy of Tuina on pain relief of different diseases has been proven, such as non-speci c chronic neck pain [29], tension-type headache [30], as well as chronic fatigue syndrome [31], and this therapeutic manual therapy is also helpful for the relief of anxiety and depression [32,33]. In addition, owing to the low requirements for equipment, the process and duration of Tuina are exible and adjustable, which to some extent reduces the potential risk of therapeutic damage brought by other physical therapies.…”