Efficacy of invasive techniques in physical therapy for migraine treatment and prevention: a systematic review of randomized controlled trials
Abstract
INTRODUCTION Approximately 14% of the world population suffers from migraine, a highly debilitating idiopathic primary headache1. The classification and diagnosis of migraines are carried out according to the International Classification of Headache Disorders (ICHD-3), based primarily on monthly migraine frequency and the manifestation of aura. More than 15 attacks per month is considered chronic and ≤15 episodic2. The etiology of this autonomic dysfunction is unclear, but a plausible hypothesis suggests peripheral and/or central sensitization. Generally, a migraine attack develops in three or four successive stages in which the onset of pain is determined by the trigeminal-vascular system. Parasympathetic activity increases in the intracranial arteries and fires the first-order neurons of this structure, sending nociceptive information from the durometer to the trigeminal ganglion. The information is then forwarded to the brainstem, in the spinal trigeminal nucleus (STN), via second-order trigeminal vascular neurons. The trigeminovascular neurons of the third-order STN are located in the thalamus, and from there, the nociceptive information is finally sent to the somatic-sensory cortex3. Migraine medication is known to induce moderate-to-severe adverse effects, and the prophylactic treatments’ effectiveness is only 50–60%, further decreasing in the chronic modality4,5. Nonpharmacological treatments for migraine prophylaxis include physical activity, relaxation, and…
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