A Twelve Month Clinical Trial of Chiropractic Spinal Manipulative Therapy for Migraine

OBJECTIVE To assess the efficacy of Chiropractic spinal manipulative therapy (SMT) in the treatment of migraine. DESIGN A prospective clinical trial of twelve months duration. The trial consisted of 3 stages: two month pre-treatment, two month treatment, and two months post treatment. Comparison of outcomes to the initial baseline factors was made and also 6 months after the cessation of the study. SETTING Chiropractic Research Centre of Macquarie University. PARTICIPANTS Thirty two volunteers, between the ages of 20 to 65 were recruited through media advertising. The diagnosis of migraine was based on a self reported detailed questionnaire, with minimum of one migraine per month. INTERVENTIONS Two months of chiropractic SMT at vertebral fixations determined by the practitioner, through orthopedic and chiropractic testing. MAIN OUTCOME MEASURES Participants completed diaries during the entire trial noting the frequency, intensity (visual analogue score), duration, disability, associated symptoms and use of medication for each migraine episode. RESULTS The initial 32 participants showed statistically significant (p < 0.05) improvement in migraine frequency, VAS, disability, and medication use, when compared to initial baseline levels. A further assessment of outcomes after a six month follow up (based on 24 participants), continued to show statistically significant improvement in migraine frequency (p < 0.005), VAS (p < 0.01), disability (p < 0.05), and medication use (p < 0.01), when compared to initial baseline levels. In addition, information was collected regarding any changes in neck pain following chiropractic SMT. The results indicated that 14 participants (58%) reported no increase in neck pain as a consequence of the two months of SMT. Five participants (21%) reported a slight increase, three participants (13%) reported mild pain, and two participants (8%) reported moderate pain. CONCLUSION The results of this study support the hypothesis that Chiropractic SMT is an effective treatment for migraine, in some people. However, a larger controlled study is required.