Introduction: According to the French National Institute of Health and Medical Research (INSERM), approximately 15% of the global population is affected by migraine. However, the actual prevalence remains uncertain, as many individuals do not routinely seek medical care and resort instead to self-medication. In France, as reported by AMELI, around one-third of individuals with migraine in 2023 did not receive comprehensive medical follow-up. This information gap underscores the need for an improved understanding of the condition and the available treatments to optimise patient care.
Objective: The primary objective of this study is to evaluate the role of manual therapy in the management of migraine, with a view to potentially reducing the frequency and severity of attacks. Through a systematic and critical review of the literature, the aim is to highlight the most appropriate approaches for managing migraine through manual therapy.
Methods: A literature search was conducted using PubMed, PEDro, and the Cochrane Library databases for articles published between 1963 and 2024. Keywords included: headache, migraine disorder, manual therapy, physical therapy, musculoskeletal manipulation. The quality of each study was assessed using the SIGN grading system for randomised controlled trials (RCTs).
Results: Seven randomised controlled trials (RCTs), involving 453 participants, were selected. The findings suggest that Chiropractic manipulations (high-velocity low-amplitude [HVLA], Gonstead technique), as well as soft tissue relaxation techniques, may be effective in managing migraines (in terms of intensity, frequency, and duration of episodes) and associated comorbidities. Furthermore, these interventions appear to reduce the use of analgesic medications.
Discussion/conclusion: Manual therapy, including spinal manipulations and soft tissue techniques, may represent a viable therapeutic option for modulating the intensity, frequency, and duration of migraine attacks.
Author keywords: Migraine - Manual therapy - Systematic review - Headache - Manipulation - Soft tissue - Gonstead - HVLA - LVHA - Trigger point - Active Release Technique
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