Posts for tag: headache

Effectiveness of Adjustments in Chronic Migraine: Armed Randomized Controlled Trial. Complementary Therapies in Medicine. April 2015; Vol. 23; No. 2; pp. 149—156


Francesco Cerritelli, Liana Ginevri, Gabriella Messi, Emanuele Caprari, Marcello Di Vincenzo, Cinzia Renzetti, Vincenzo Cozzolino, Gina Barlafante, Nicoletta Foschi, Leandro Provincial: This study was carried out in the Department of Neurology of Ancona’s United Hospitals, Ancona, Italy. This article has 54 references.

The primary measurement outcome in this study is the Headache Impact Test (HIT-6); below is the conclusion from the cited reference:

“Our study shows that the HIT-6 is a reliable and valid tool for measuring the impact of headache on daily life in both episodic and chronic migraine sufferers. Furthermore, the HIT-6 tool discriminates well between chronic migraine, episodic migraine and non-migraine patients. As a brief tool, the HIT-6 is easy to score and interpret, and can be readily integrated into clinical practice, or clinical studies of migraine patients. It may offer clinicians a practical and easy-to implement tool to assist them with evaluating treatment effectiveness by obtaining input directly from the patient on aspects other than just the frequency of headache days.”


1) “This manipulative therapy trial is the largest ever conducted on migraine adult patients.” These authors assessed the effectiveness of manipulative treatment on 105 chronic migraine patients using:

• Headache Impact Test (HIT-6) questionnaire [main outcome measure]

• Drug consumption

• Days of migraine

• Pain intensity

• Functional disability

2) This is a randomized controlled trial. Patients received 8 treatments over a period of 6 months. Patients were randomly divided into three groups:

 • Manipulation + medication therapy n=35

•• The manipulative techniques used in this study included myofascial release, treatment of ligamentous and membrane tensions, treatment of somatic dysfunctions, and treatment to asymmetries and imbalances in the pelvis and cranium.

• Sham manipulation + medication therapy n=35

•• The sham group received a false manipulation, in addition to drug care.

•• Sham therapy mimicked the manipulative care in terms of evaluation and treatment; it used light manual contact to ‘‘treat’’ the subject.

•• Both manipulative and sham therapy sessions lasted 30 minutes and were given weekly for the first two sessions, biweekly for the subsequent two, then monthly for the remained four sessions.

• Medication only n=35

3) “Migraine attacks are usually characterized by a unilateral and pulsating severe headache, lasting 4—72 hours, and are often associated with nausea, phono- and photophobia.”

4) “Migraine is a serious public health concern of considerable consequences to both the migraineur and society.”

5) The overall migraine prevalence in Europe is 10—15% of the population.

6) These authors make the following points pertaining to the etiology of migraine:

• In 20% of migraineurs, the attacks are anticipated by transient neurological symptoms, the aura.

• Migraine has a genetic etiology in about 50% of cases.

• Migraine etiology also has multifactorial epigenetic mechanisms.

• During a migraine attack, high levels of inflammatory cytokines are released causing neurogenic inflammation of the meninges and transmitting pain signals to the trigeminovascular system and autonomic nervous system nuclei.

7) Criteria considered for manipulative evaluation and treatment were:

• Alteration of tissue consistency

• Asymmetry

• Range of motion restriction

• Tenderness

8) During migraine attacks, high levels of pro-inflammatory substances are released, altering neural autonomic pathways.

9) Manipulation influences the autonomic nervous system by producing a parasympathetic effect, and therefore, a “trophotropic tuning state.”

10) Manipulation is associated with a “reduction of pro-inflammatory substances.”

11) Manipulation in migraineurs could reduce the release of pro-inflammatory substances that have an effect on the autonomic nervous system function. “As a consequence, a cascade of biological and neurological events, potentially based on a rebalance of the abnormal activation of the habituation/sensitization mechanism, even between attacks, could occur resulting in an overall improvement of clinical outcomes.”

12) Manipulation “significantly reduced the frequency of migraine.”

13) At the end of the study period, there was a statistically significant difference on the overall HIT-6 score between the three groups; the manipulation group was statistically improved from control [drug only] and sham group.

14) “Considering migraine days per month, the three groups differed significantly at the end of the study period.”

15) Manipulation “significantly reduced the number of subjects taking medications.”

16) “No study participant reported any adverse effects of the [manipulation].”

17) “Migraine attacks, use of drugs, pain and disability scores were significantly reduced in the OMT group.”

18) “OMT showed a significant improvement in the migraineurs’ quality of life.”

19) Interestingly, the “sham group significantly reduced the HIT-6 score compared to the conventional [drug only] care. “The magnitude of the results suggests that the sham procedure may be clinically effective.” [Important]

20) The sham treatment used soft touch, which will induce responses at different levels of the central nervous system, reducing pain and improving well-being.

21) “The use of osteopathy [manipulative therapy] as an adjuvant therapy for migraine patients may reduce the use of drugs and optimize the clinical

management of the patients.”

22) “The present study showed significant differences between OMT group compared to drug and sham groups, suggesting that OMT may be considered a clinically valid procedure for the management of patients with migraine.”



It is important to look at the numbers in the table and the graph in this Review. Again, it is noteworthy that sham manipulation is superior to drug-only treatment for migraine. Note that manipulation essentially eliminated migraine days per month, pain, disability, and reduced drug consumption by 80%. Note that for the group assigned to taking drugs-only, there was essentially no reduction in migraine days per month, pain, disability, and no reduction in drug consumption.

Our interpretation of this data is that it appears that manipulation is actually addressing the causative pathophysiology of migraine headache; in contrast, it appears that taking drugs is nothing more than temporary pain control with no benefit to the causative pathophysiological of migraine headache. We remain perplexed as to why any healthcare delivery system would favor drugs for migraine (and many other pain syndromes) over mechanical therapy.  $  ??? 

By Kenneth P. Clenin, DC, CCRD, CSCS
September 11, 2014
Tags: chiropractor   headache  

How Your Chiropractor Can Treat Your Headaches

Unfortunately, a headache can strike at any possible moment. Most of the time it might feel that it comes on during the worst times possible—like when we’re at work or even sitting in a college lecture. Once a headache shows up, it can be a challenge to even be able to concentrate on anything other than the pain and discomfort you’re feeling.

You might try to massage your temples or neck and hope that it goes away; however, it’s obvious that nothing is going to get accomplished until you make this pain go away. A headache can really put a damper on your whole day. And if you experience chronic headaches in Memphis, you might be desperate to find a treatment to alleviate symptoms. Did you know that your relief could actually come from visiting a chiropractor in Memphis, TN? It might seem hard to believe but chiropractic care has been successful in treating those with chronic headaches.

Understanding Chiropractic Care

Here are just a few interesting facts about chiropractic care in Memphis and how it can benefit you:


-       One main cause of pain and disorders is improper alignment of the vertebrae in the spine. Chiropractic care in 38119 works to fix this misalignment by using a combination of pressure, massage and manipulation. Through these techniques, any pressure placed on these spinal nerves is released, helping to loosen up joint mobility. This is your body returning to homeostasis—or its happy place.

-       Chiropractic care in Memphis has been used for a multitude of reasons, including reducing joint injury pain and osteoarthritis; however, we’ve also realized that chiropractic care also lessen symptoms of other conditions including high blood pressure, ear infections, and of course, headaches. In fact, in the last couple of decades, we’ve finally recognized the usefulness of chiropractic care in Memphis, TN on neuromuscular conditions.

-       A 2001 study conducted at Duke University found that spinal manipulation actually improved headaches that originated in the neck. They also found that spinal manipulation produced fewer side effects and longer relief of tension headaches than more commonly used medications. This study further supports that our chiropractic treatments help chronic headache sufferers in the 38119 area.

If you’ve never seen a chiropractor and you’re wondering what this treatment entails, your chiropractor in Memphis offers an array of treatments including electrotherapy, massage therapy, physical rehabilitation, ice/heat therapy and stress management. However, one of the main functions of treatment is to fix improper spine alignment, which in turn, could help solve your headache problems.

If you feel like headaches are interfering with your life, it’s time to do something about it. If you’re interested in how your Memphis chiropractor could help, then call us at (901) 683-5971.

Has Memphis chiropractic care helped reduce your headache symptoms? If so, we would love to know more about your experience. How long was it before you noticed a reduction in symptoms? Has it helped you feel more productive? We would love to hear from you.