Reduction of current migraine headache pain following neck massage and spinal manipulation

Abstract

Background: Migraine headache significantly impacts the health of individuals and of society. The application of simple physical nonpharmacological techniques could greatly reduce the therapeutic costs and side effects in acute onset of such headaches.

Methods: Ten male patients (mean age was 32.0 ± 10.59 years) with acute onset of a migraine headache according to IHS-2004 diagnostic criteria were enrolled in the study. Neck and upper thoracic spine massage and manipulation technique was performed. Headache pain intensity was assessed before and after the intervention by means of a verbal analog scale.

Results: Following treatment, headache pain intensity was significantly reduced compared to the pretreatment values (1.85 ± 1.11 vs. 5.80 ± 2.25, p = .005). As a percentage, this represents a mean pain reduction of 68.77% ± 18.56. No side effects were observed, and all of the patients reported satisfaction with the intervention.

Conclusion: Our results show that the applied cervical and upper thoracic massage and manipulation technique could reduce the headache attack pain intensity in patients with migraine headaches, though further testing, including study designs that make use of control groups, is needed.

Keywords: abortive treatment; cervical spine manipulation; migraine; neck massage.

Figure 1

The patients were asked to lean on the chair back-rest in a relaxed position with their hands hanging from their sides.

Figure 2

The therapist massaged the trapezius and the supraspinatus fibers in a down–upward and lateral direction between T3 and C7 vertebrae levels three to five times.

Figure 3

Massage and relaxation of the neck muscles: (A) the method of holding the patient’s head by the therapist, (B) longitudinal, and (C) horizontal. The position of holding the patient’s head by the therapist is of extreme importance (please refer to the text).

Figure 4

Manipulation of the cervical spine; note the head rotation manoeuvre. Putting the head in its maximum movement limit makes a resistance point such that going beyond this limit produces a popping sound from the spinal joints.

Figure 5

Manipulation of the upper thoracic spine: the therapist has to pass his hands from the triangular space forward (A) and put them on the patient’s interlaced hands (B).

Figure 6

The reduction in the headache pain score was statistically significant after treatment (p=.005 for comparison of before and just after manipulation average pain scores; and p<.0001 for comparison of three successive measurements of average pain scores).