Body-Based Practices for Migraine
By: Brooklyn A. Bradley, BS; Medically edited by Dr. Deena Kuruvilla, MD
Introduction:
This week’s blog post will conclude our series on complementary and integrative medicine (CIM) with the discussion of manipulative and body-based practices. There is a category of CIM that involves the movement or manipulation of an area of the body in order to help manage a disease. Manipulative and body-based practices can be used for pain, stress, anxiety, depression, migraine, and more. In terms of migraine, the types of body-based practices we will be discussing today include acupuncture, massage therapy, and chiropractic therapy.
Acupuncture:
Acupuncture is the practice of applying small needles or pressure to specific points in the body. The goal of acupuncture is to align qi, which directly translates to “vital energy” (1). There are five elements to qi, including wood, water, fire, earth, and metal. The idea is that if one of these is blocked or in excess, vital energy is disrupted. Acupuncture focuses on the many variables contributing to wellness, with the goal of restoring wellness (1). Acupuncture is a nonpharmacological treatment option that has been used for various diseases, including migraine.
There is a lack of high-quality evidence on the effectiveness of acupuncture for migraine. However, there are some studies that investigate the use of acupuncture as a preventive therapy for migraine. A study in 2005 found that acupuncture was more effective than the non-treatment group in decreasing the number and intensity of headache days following 12 weeks of acupuncture therapy (2). A study identifying the long-term effects of acupuncture for migraine compared patients treated with acupuncture versus patients with no treatment (3). The frequency of attacks decreased in the acupuncture group in comparison to the non-treatment group. The researchers suggested that in people with migraine , acupuncture may be associated with long-term reduction in migraine recurrence (3).
The health benefits of acupuncture are variable. Some side effects of acupuncture may include pain or bleeding from the needle insertion, nausea, bruising, and dizziness (4). Overall, it is best to speak with your headache specialist before getting acupuncture, because it may not be appropriate.
Massage Therapy:
Massage therapy is a common practice among many cultures, and it particularly has an important role in traditional Chinese and Indian medical care (5). Massage therapy involves the manipulation of the soft tissue of whole body areas. The goal of massage therapy is to improve health and provide specific physical benefits, which may include a decrease in muscular aches and pains. A massage treatment can be applied in a variety of forms depending on the individual’s condition or degree of symptoms (5). Massage therapy may be used for migraine patients, aiming to reduce pain and improve quality of life. It often targets areas of the body that may harbor stress or tension, which are often migraine triggers.
In a study determining the effects of massage therapy on migraine experience, people with migraine were either placed in the massage treatment group or a control (non-treatment) group (6). The massage participants received massage sessions for 5 weeks. Following the study, massage patients experienced improvements in migraine frequency and sleep quality during the study and at the 3-week follow-up. In addition, massage decreased anxiety, heart rate, and cortisol (stress hormone) levels (6). In a 2016 study investigating the use of lymphatic drainage (reduce swelling in arms and legs) and massage as a preventive treatment of migraine, patients were asked to fill a headache diary throughout the study period (7). The number of migraine attacks and days decreased in the lymphatic drainage and massage groups. In addition, there was a reduction of migraine attack frequency (7).
The studies mentioned above offer preliminary support for the use of massage therapy as a nonpharmacologic treatment option for migraine patients. Possible negative effects include physical injury, for example, bruises and nerve irritation.
Chiropractic Therapy:
The goal of chiropractic therapy is to restore and protect wellbeing, specifically in the spine and musculoskeletal system (8). Chiropractors typically focus on specific joint manipulations by stretching and applying pressure. These manipulations are typically performed on the spine (8). In the case of migraine, chiropractors will manipulate the spine in order to reduce stress and improve spinal function. However, chiropractic maneuvers can have negative side effects.
In a study identifying the usefulness of chiropractic spinal manipulative therapy in the treatment of migraine, patients in the chiropractic treatment group received two months of migraine care (9). There was an improvement in migraine frequency, duration, disability, and medication use in the chiropractic treatment group. 22% of patients reported at least a 90% reduction of migraine attacks following the 2 months of chiropractic treatment (9). A 2016 study of chiropractic spinal manipulative therapy for migraine also found that post-treatment migraine patients experienced a reduction in migraine days (10). However, the researchers questioned the significance of the results (10).
While there may be evidence that chiropractic therapy is effective for migraine, there is also the potential for adverse effects. One of the possible effects is,cervical vessel dissection following neck manipulation (11). Cervical artery dissection is a tear in one layer in the artery wall, which is a common cause of stroke in young people (12). In addition, there has been a case of a 32-year-old woman who had chiropractic manipulation and passed away after experiencing a vertebral artery dissection as a result of the therapy (13). It is of utmost importance to review chiropractic manipulation with your physician before initiating therapy.
Conclusion:
Acupuncture, massage therapy, and chiropractic therapy are all nonpharmacological treatments used for a variety of diseases and symptoms. These therapies are used for the management of migraine, but not without mainstream migraine treatments. There is the potential for side effects from some of these therapies. As always, it is best to discuss these options with your headache specialist or the physician managing your migraine disease.
References:
- Van Hal M, Dydyk AM, Green MS (2022) Acupuncture. In: StatPearls. StatPearls Publishing, Treasure Island (FL)
- Linde K, Streng A, Jürgens S, et al (2005) Acupuncture for Patients With MigraineA Randomized Controlled Trial. JAMA 293:2118–2125. https://doi.org/10.1001/jama.293.17.2118
- Zhao L, Chen J, Li Y, et al (2017) The Long-term Effect of Acupuncture for Migraine Prophylaxis: A Randomized Clinical Trial. JAMA Internal Medicine 177:508–515. https://doi.org/10.1001/jamainternmed.2016.9378
- What Is Acupuncture and What Are the Benefits? In: Verywell Health. https://www.verywellhealth.com/acupuncture-health-uses-88407. Accessed 28 Aug 2022
- Vickers A, Zollman C, Reinish JT (2001) Massage therapies. West J Med 175:202–204
- Lawler SP, Cameron LD (2006) A randomized, controlled trial of massage therapy as a treatment for migraine. Ann Behav Med 32:50–59. https://doi.org/10.1207/s15324796abm3201_6
- Happe S, Peikert A, Siegert R, Evers S (2016) The efficacy of lymphatic drainage and traditional massage in the prophylaxis of migraine: a randomized, controlled parallel group study. Neurol Sci 37:1627–1632. https://doi.org/10.1007/s10072-016-2645-3
- Salehi A, Hashemi N, Imanieh MH, Saber M (2015) Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews. Int J Community Based Nurs Midwifery 3:244–254
- Tuchin PJ, Pollard H, Bonello R (2000) A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics 23:91–95. https://doi.org/10.1016/S0161-4754(00)90073-3
- Chaibi A, Benth JŠ, Tuchin PJ, Russell MB (2017) Chiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial. Eur J Neurol 24:143–153. https://doi.org/10.1111/ene.13166
- Kennell KA, Daghfal MM, Patel SG, et al (2017) Cervical artery dissection related to chiropractic manipulation: One institution’s experience. J Fam Pract 66:556–562
- Lian Y-H, Chen X, Kong D-R, et al (2020) Cervical artery dissection—an easily neglected cause of stroke: a case report. BMC Neurology 20:428. https://doi.org/10.1186/s12883-020-02006-6
- Turner RC, Lucke-Wold BP, Boo S, et al (2018) The potential dangers of neck manipulation & risk for dissection and devastating stroke: An illustrative case & review of the literature. Biomed Res Rev 2:. https://doi.org/10.15761/BRR.1000110