Abstract
Objective: To assess the efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment
of migraine. Design: A randomized controlled trial of 6 months' duration. The trial consisted of 3 stages:
2 months of data collection (before treatment), 2 months of treatment, and a further
2 months of data collection (after treatment). Comparison of outcomes to the initial
baseline factors was made at the end of the 6 months for both an SMT group and a control
group. Setting: Chiropractic Research Center of Macquarie University. Participants: One hundred twenty-seven volunteers between the ages of 10 and 70 years were recruited
through media advertising. The diagnosis of migraine was made on the basis of the
International Headache Society standard, with a minimum of at least one migraine per
month. Intervention: Two months of chiropractic SMT (diversified technique) at vertebral fixations determined
by the practitioner (maximum of 16 treatments). Main outcome measures: Participants completed standard, headache diaries during the entire trial noting
the frequency, intensity (visual analogne score), duration, disability, associated
symptoms, and use of medication for each migraine episode. Results: The average response of the treatment group (n = 83) showed statistically significant
improvement in migraine frequency (P <.005), duration (P <.01), disability (P <.05), and medication use (P <.001) when compared with the control group (n = 40). Four persons failed to complete
the trial because of a variety of causes, including change in residence, a motor vehicle
accident, and increased migraine frequency. Expressed in other terms, 22% of participants
reported more than a 90% reduction of migraines as a consequenc of the 2 months of
SMT. Approximately 50% more participants reported significant improvement in the morbidity
of each episode. Conclusion: The results of this study support previous results showing that some people report
significant improvement in migraines after chirupractic SMT. A high percentage (>80%)
of participants reported stress as a major factor for their migraines. It appears
probable that chiropractic care has an effect on the physical conditions related to
stress and that in these people the effects of the migraine are reduced. (J Manipulative
Physiol Ther2000;23:91–5)
Keywords
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References
- Migraine—not just a headache.Migraine Foundation of Australia, Sydney1996
- Undiagnosed migraine: a comparison of symtom-based and physician diagnosis.Arch Intern Med. 1992; 152: 1273-1278
- Migraine in the workplace. Brainwaves.in: Australian Brain Foundation, Hawthorn, Victoria1995: 1-4
- The economic cost of migraine: present state of knowledge.Neurology. 1994; 44: S56-S62
- Classfification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain.Cephalalgia. 1988; 8: 1-96
- A concept of migraine and the search for the ideal headache drug.Headache. 1990; 1: 17-23
- The pathology of migraine.Clin J Pain. 1990; 6: 235-239
- Cardiovascular system.in: Mims Annual. Mims Australia, Sydney1995: 158-163
- 5-Hydroxytryptamine and its putative aetiological involvement in migraine.Cephalalgia. 1989; 9: 7-13
- Serotonin metabolism in migraine.Neurology. 1989; 39: 1239-1242
- The pathology of migraine.Clin J Pain. 1990; 6: 235-239
- Migraine prevention with timolol. A double-blind crossover study.JAMA. 1984; 252: 2576-2580
- Migraine prophylaxis. A comparison of propranolol and amitriptyline.Arch Neurol. 1987; 44: 486-489
- Cervicogenic headache, migraine without aura and tension-type headache. Diagnostic blockade of greater occipital and supra orbital nerves.Pain. 1992; 51: 43-48
- The central serotoninergic system.Cephalalgia. 1990; 10: 199-204
- A double-blind study of subcutaneous dihydroergotamine versus subcutaneous sumatriptan in the treatment of acute migraine.Arch Neurol. 1996; 53: 180-184
- Classic migraine or not classic migraine, that is the question.Aust J Chiropr Osteo. 1996; 5: 66-74
- The tension headache, migraine continuum: a hypothesis.J Manipulative Physiol Ther. 1994; 17: 157-167
- Interactions between migraine and tension type headaches in the general population.Arch Neurol. 1992; 49: 914-918
- Musculoskeletal dysfunction of the neck in migraine and tension headache.Headache. 1993; 33: 566-569
- The mechanism and treatment of migraine and other disorders of cervical and postural dysfunction.Cephalgia. 1989; : 381-382
- The efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment of migraine—a pilot study.Aust Chiro Osteo. 1997; 6: 41-47
- Cervical causes of headache and dizziness.in: 2nd ed. Modern manual therapy of the vertebral column. Churchill Livingstone, Edinburgh1994: 317-331
- Cervicogenic dysfunction in muscle contraction headache and migraine: a descriptive study.J Manipulative Physiol Ther. 1992; 15: 418-429
- Inhibition by sumatriptan of central trigeminal neurons only after blood-brain barrier disruption.Br J Pharmacol. 1993; 109: 788-792
- The safety profile of sumatriptan.Rev Contemp Pharmacother. 1994; 5: 319-328
- 5-Hydroxytryptamine and its putative etiological involvement in migraine.Cephalgia. 1989; : 7-13
- Cervical headache: a review.in: 2nd ed. Modern manual therapy of the vertebral column. Churchill Livingstone, Edinburgh1994: 333-346
Pikus HJ, Phillips JM. Outcome of surgical decompression of the second cervical root for cervicogenic headache. Neurosurg 39:63–71.
- Spinal manipulation and headache of cervical origin.J Manipulative Physiol Ther. 1989; 12: 455-468
- Cervicogenic headache, C2 rhizopathy, and occipital neuralgia: a connection.Cephalgia. 1986; 6: 189-195
- Migraine and tension type headaches: the questionable validity of current classification systems.Pain. 1992; 8: 28-36
- A Case study of chronic headaches.Aust Chiro Osteo. 1996; 5: 47-53
- Cardiovascular adverse reactions to sumatriptan: cause for concern?.CNS Drugs. 1995; 3: 90-98
- The safety profile of sumatriptan.Rev Contemp Pharmacother. 1994; 5: 319-328
- Spinal manipulations vs Amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial.J Manipulative Physiol Ther. 1995; 18: 148-154
- A randomized clinical trial of the effect of spinal manipulations for the treatment of cervicogenic headache.J Manipulative Physiol Ther. 1995; 18: 435-440
- A controlled trial of cervical manipulation for migraine.Aust NZ J Med. 1978; 8: 585-593
- The efficacy of cervical manipulation as opposed to pharmocological therapeutics in the treatment of migraine patients. Transactions of the Consortium for Chiropractic Research.1987
Article info
Publication history
Received:
June 29,
1999
Footnotes
*Submit reprint requests to: Peter J. Tuchin, GradDipChiro, DipOHS, Department of Chiropractic, Ste 222, Building E7A, Macquarie University 2109, NSW Australia.
Identification
Copyright
© 2000 JMPT. Published by Elsevier Inc. All rights reserved.
