Effectiveness of manual therapy as a prophylactic treatment for migraine: a randomized controlled trial
Abstract
ABSTRACT Introduction: Migraine is a leading cause of disability worldwide. Although effective, the use of pharmacological prophylaxis is low due to suboptimal efficacy and poor tolerability. This has led to a growing interest in non-pharmacological approaches such as manual therapy (MT), especially among patients with comorbid neck pain. While evidence for MT remains inconclusive, its adjunctive use is recommended. This study evaluated the effect of MT in patients with migraine and neck pain, compared to usual care provided by general practitioners (UC). Methods: In this randomized controlled trial in primary care, participants with migraine and neck pain were allocated to MT (n = 36) or UC (n = 31). MT included mobilizations, exercises and myofascial techniques. Follow-up assessments were performed at 12-, 26-, and 52-weeks post-inclusion. The primary outcome was the number of migraine days. Secondary outcomes included migraine intensity, disability, medication use, neck pain intensity, neck muscle endurance, pressure pain thresholds, allodynia, and perceived recovery. Results: There were no significant between-group differences in migraine days or most secondary outcomes. Compared with usual care, the MT group demonstrated significantly higher-pressure pain thresholds over the occipital muscles and reported greater perceived recovery at both 12 and 52 weeks. Use of prophylactic medication was higher in the UC group throughout follow-up. Conclusion: MT, including postural…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 36 participants or records.
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