Effects of Transcutaneous Occipital Nerve Stimulation and Instrument-Assisted Soft Tissue Mobilization in Chronic Migraine

Published:October 28, 2022DOI:



      The purpose of this study was to examine the effects of transcutaneous occipital nerve stimulation (TONS) and instrument-assisted soft tissue mobilization (IASTM) on pain, sleep, and quality of life in patients with chronic migraine.


      Forty-five female patients with chronic migraine were randomly assigned to control (n = 15), IASTM (n = 15), and TONS (n = 15) groups. Neck exercises were given to all groups once per day for 5 weeks. IASTM, using a smooth metal scraping massage tool, was applied to the patients in the IASTM group twice per week for 5 weeks. Patients in the TONS group were treated with transcutaneous electrical nerve stimulation 3 times per week for 5 weeks. The outcome measures were a Numeric Pain Scale, the Headache Impact Test-6, the Pittsburgh Sleep Quality Index, and the Short Form-36.


      The IASTM and TONS groups had significantly lower mean Headache Impact Test-6 scores than the control group in the last measurement (F = 3.908, P = .028). The IASTM and TONS groups had lower mean Numeric Pain Scale scores than the control group (F = 13.861, P = .001). The IASTM group had a lower mean Pittsburgh Sleep Quality Index score in the last measurements than the other 2 groups (F = 6.792, P = .003). There was no difference between the groups in the general health perception scores obtained in the last measurements (F = 1.585, P = .217). In the last measurement, the IASTM and TONS groups had higher mean general health scores than the control group.


      IASTM and TONS applications reduced head and neck pain and improved sleep and quality of life in patients with chronic migraine. Neither had superiority over the other.

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