Chiropractic Spinal Manipulation Therapy: An Effective Treatment of Migraines
Jaime McAuliffe, Kelli-Jo Richard, Matthew Shem, Abigayle Welch
Objective:
Is Chiropractic Spinal
Manipulative Therapy (CSMT)
an effective treatment option
for reducing the intensity and
frequency of migraine-type
headaches? If so, is it
statistically significant when
compared to conventional
methods of non-manual
therapy? These are vital
questions for defining
Chiropractic autonomy and
the conditions it can be used
to treat.
Search Terms:
Spinal Manipulative Therapy,
Migraine, Headache,
Chiropractic, Randomized
Control Trial, Pharmacology,
Placebo
Data Sources:
PubMed, National Center for
Biotechnology Information
Results:
A single-blinded, placebo RCT showed that CSMT resulted in significant improvement in
migraine frequency and intensity when compared to non-manual therapy during treatment.
Post-treatment follow up demonstrated reduced pharmaceutical intervention in patients who
received CSMT as opposed to control or placebo (1). During treatment, CSMT,
pharmaceutical intervention, and a combination of both therapies all resulted in significant
improvement in both primary and secondary outcomes of reduced headache index scores.
Post-treatment follow-up demonstrated a notable reduction of intensity in patients who
received CSMT as opposed to those who received pharmaceutical intervention or combined
therapies (3). In a RCT, post-treatment follow up showed a 90% reduction in migraine
frequency in 22% of participants. About 75% of participants reported significant
improvement in the intensity of each migraine (2). Adverse effects were more frequent in
CSMT than the placebo intervention sessions. The most common reported was local
tenderness and no severe or serious AEs were reported (1).
Discussion:
These studies allow us to see the long-term effects of CSMT on patients suffering from
migraine headaches as opposed to the long-term effects of pharmaceutical intervention (1).
This study allows chiropractors to gain further knowledge in regard to their patients with
migraine headaches and how to better their patient education. Patient education may now
include these statistics to show the benefits of CSMT for patients suffering from migraines
who may have been told a prescription is the only way to subdue their symptoms (3). It
would behoove chiropractors to disseminate this information because it shows that not only
did the frequency decrease but there is significant decrease in intensity of subsequent
migraines.
Conclusion:
CSMT is supported as a beneficial method of treatment
for patients with migraine headaches because of its
efficacy on reduction of symptoms, frequency, duration,
and intensity of migraines. The use of CSMT shows
only benign side effects in comparison to
pharmaceutical interventions and should be considered
as an alternative option of care. There are no added
benefits of combining both CSMT and pharmaceuticals,
CSMT has shown positive results when used alone. I
challenge these studies to follow up with the
participants long term and to record data from further
care. For future research, it would be beneficial to
analyze migraines in existing chiropractic patients as
well as the success rates in narrower age ranges, i.e.
pediatric population compared to teens, adults, and
elderly.
References:
1. Chaibi A, Benth J, Tuchin P, Russell M. Chiropractic spinal manipulative
therapy for migraine: a three-armed, single-blinded, placebo, randomized
controlled trial. European Journal of Neurology. 2016;24(1):143-153.
2. Tuchin P, Pollard H, Bonello R. A randomized controlled trial of
chiropractic spinal manipulative therapy for migraine. Journal of
Manipulative and Physiological Therapeutics. 2000;23(2):91-95.
3. Nelson C, Bronfort G, Evans R, Boline P, Goldsmith C, Anderson A. The
efficacy of spinal manipulation, amitriptyline and the combination of both
therapies for the prophylaxis of migraine headache. Journal of
Manipulative & Physiological Therapeutics. 1998;21(8):511-9.