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A Randomized Controlled Trial of Chiropractic Spinal Manipulative Therapy for Migraine

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A Randomized Controlled Trial of Chiropractic Spinal Manipulative Therapy for Migraine

Recurrent headache treatments, including manual therapy for migraine, are increasingly being investigated. Unfortunately, there has been little reliable data regarding the effectiveness of chiropractic spinal manipulative therapy (CSMT) for migraine. To fully comprehend CSMT’s potential in treating migraine and determine if it works effectively in a controlled setting, more research is necessary.

In a three-arm randomized controlled trial, the effectiveness of CSMT for migraine was examined. One arm served as a placebo (sham manipulation), and two others received usual non-manual migraine management (ECM).

At least 61 women with recurrent migraines who met eligibility criteria were randomly assigned to either the multimodal chiropractic care intervention + enhanced usual care (EUC) or EUC alone groups. Participants were assigned their treatment group based on their prophylactic migraine medication use and migraine frequency during a run-in period (4-7 migraines/month or 8-13 migraines/month).

All participants completed daily migraine logs for 4 to 13 days during the run-in phase. Additionally, they completed assessments of migraine frequency, pain intensity, and headache index at baseline and after 14 weeks of intervention.

Participants in both groups (CSMT + EUC and EUC alone) were required to complete 14- and 18-week follow-up questionnaires. At 18 weeks, those in CSMT and placebo groups reported fewer migraine days than their counterparts (P 0.001).

Migraine duration, intensity and headache index were significantly reduced from baseline to post-treatment in all three arms; the effect persisted throughout the 12-month follow-up period. Furthermore, paracetamol consumption per day also decreased along with this reduction in migraine frequency.

This is the first randomized controlled trial to investigate the effectiveness of manual manipulation as a migraine treatment, marking an important development in integrative health research. Manual therapies have often been difficult to incorporate into RCTs due to their potential to affect patients through direct physical contact; using a sham procedure as a control to guarantee validity of outcome measurement was an essential step toward including this technique into RCT “boxes.”

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