A randomized controlled trial of chiropractic spinal manipulative therapy for migraine

Objective: To assess the efficacy of chiropractic spinal manipulative thera py (SMT) in the treatment of migraine. Design: A randomized controlled trial of 6 months' duration. The trial cons isted of 3 stages: 2 months of data collection (before treatment), 2 months of treatment, and a further 2 months of data collection (after treatment). Comparison of outcomes to the initial base-line factors was made at the en d of the 6 months for both an SMT group and a control group. Setting: Chiropractic Research Center of Macquarie University. Participants: One hundred twenty-seven volunteers between the ages of 10 an d 70 years were recruited through media advertising. The diagnosis of migra ine was made on the basis of the International Headache Society standard, w ith a minimum of at least one migraine per month. Interventions: Two months of chiropractic SMT (diversified technique) at ve rtebral fixations determined by the practitioner (maximum of 16 treatments) . Main Outcome Measures: Participants completed standard headache diaries dur ing the entire trial noting the frequency, intensity (visual analogue score ), duration, disability, associated symptoms, and use of medication for eac h migraine episode. Results: The average response of the treatment group (n = 83) showed statis tically significant improvement in migraine frequency (P < .005), duration (P < .01), disability (P < .05), and medication use (P < .001) when compare d with the control group (n = 40). Four persons failed to complete the tria l because of a variety of causes, including change in residence, a motor ve hicle accident, and increased migraine frequency. Expressed in other terms, 22% of participants reported more than a 90% reduction of migraines as a c onsequenc of the 2 months of SMT. Approximately 50% more participants repor ted significant improvement in the morbidity of each episode. Conclusion: The results of this study support previous results showing that some people report significant improvement in migraines alter chiropractic SMT. A high percentage (>80%) of participants reported stress as a major f actor for their migraines. It appears probable that chiropractic care has a n effect on the physical conditions related to stress and that in these peo ple the effects of the migraine are reduced.