NONPHARMACOLOGICAL TREATMENT FOR MIGRAINE - INCREMENTAL UTILITY OF PHYSICAL THERAPY WITH RELAXATION AND THERMAL BIOFEEDBACK

The identification of musculoskeletal abnormalities in headache patien ts has led to the incorporation of physical therapy (PT) into treatmen t programs for chronic headache. The current studies: (i) investigated the efficacy of PT as a treatment for migraine, and (ii) investigated the utility of PT as an adjunct treatment in patients who fail to imp rove with relaxation training/thermal biofeedback (RTB). PT alone is n ot effective in reducing headache, with only 14% of subjects reporting significant headache reduction (mean reduction of 15.6% in comparison with 41.3% in RTB). However, PT may have been a useful adjunct, with 47% of a group of 11 subjects who had failed to improve with RTB repor ting improvement with the addition of PT. It is recommended that RTB r emain the nonmedical treatment of choice for migraine, and that PT may be a useful adjunct for patients who fail to improve after such treat ment.