Migraine sufferers know the beast well. The throbbing pain, nausea, extreme sensitivity to light and noise goes far beyond the bounds of tension headaches. Lasting from hours to days, these painful events can render the sufferer unable to go about the activities of daily life. And by that we mean huddling in the quietest, darkest room you can find and hoping for the storm to pass. The question of how to lessen the frequency and severity of one’s migraines is a big question for many migraine sufferers.
A new study published in the Journal of Manipulative and Physiological Therapeutics has looked at the “expectations, attitudes and experiences of individuals with migraines” who received chiropractic care and juxtaposed these against people who did not receive chiropractic care. The results proved quite interesting.
The study was a randomised controlled trial that took 29 women who suffered from episodic migraines (anywhere from 4 – 13 migraines per month) and randomised them into two groups. The first group benefited from enhanced care alone. The second received the same enhanced care plus chiropractic care. The study took place in a “hospital-based integrative care centre.” It was part of the IMPACT initiative – the Integrative Migraine Pain Alleviation through Chiropractic Therapy project which uses multimodal migraine care approaches. It is currently a pilot program running out of the Osher Clinical Centre for Complementary and Integrative Medicine in Boston – a hospital affiliated with Harvard Medical School.
For many migraine sufferers, medication is the first line of defence in a migraine attack. But it is well-evidenced in research that there are comorbidities when it comes to migraines. Musculoskeletal complaints often enter the picture, and there can be a litany of potential triggers for clinicians and patients to wade through in efforts to manage the condition in an ongoing manner. Therefore, it is also common for migraine sufferers to seek out “holistic or integrative approaches” when it comes to managing their migraines .
Of course, chiropractic ranks among these approaches.
The current study was interview based, and patients who were randomised into the chiropractic care group received 10 sessions over the 14-week study period. The specific chiropractic protocol (detailed in the original report referenced below) was designed to be “individualized to specific patient needs and followed the scope of chiropractic” relevant to the country and state of practice.
We know that understanding pain is a complex thing: not only do we need to understand the pathology (or injury) that causes the pain, but the way the brain processes and even learns pain responses. Hence, we need to take into consideration pain habituation, pain sensitivity, and other factors that may influence a person’s response to and experience of pain. This is as true for migraine as it is for anything else.
Therefore, researchers were looking not only at the strategies migraine sufferers used to manage their chronic pain, but their interpretations of their experience as migraine sufferers.
Through-out the study, three themes emerged from the data analysis. “Participants expanded their awareness to include musculoskeletal contributions as migraine triggers; participants revised their prior conceptions of chiropractic care; and participants viewed the chiropractor-patient relationship as an essential component to effectively managing their migraines .”
While the study goes into quite some detail on each of these themes, there are some particularly interesting findings. An expanded understanding of stress and the way the body stored this stress was noted under the first theme. Participants became more aware of these changes (for example neck and shoulder tightness, stress manifesting as muscular tension and other factors they were not aware of before chiropractic care).
Interestingly, theme two involved perceptions about chiropractic care. Many participants at the beginning of the study described “wondering whether a new approach, such as chiropractic care, would help them manage their migraines.” The researchers noted limited knowledge of chiropractic care in participants as well as their descriptions typically revolving around “alignment of skeletal structures .”
They also found that “Although they recognised that stress and anxiety contributed to the intensity of their migraines, [participants] were unsure of the effectiveness of chiropractic care to address chronic stress .” Thus, the second finding of the study (being an expanded awareness of chiropractic and its offerings and modalities) was significant.
The final theme was the emergence of a collaborative relationship between chiropractor and patient. “Participants expressed the importance of trust in their experience with the chiropractor .” Given the narrower perceptions of chiropractic care noted at the beginning of the study, it is a noteworthy finding.
It has often been said that chiropractic is a care, not a treatment. Thus, this partnership between patient and chiropractor takes on vital importance as we work together to achieving the health goals of the patient. It’s wonderful to see this theme emerge from research, and we look forward to seeing what else emerges from the IMPACT initiative.
In the meantime, the original study can be found at the reference below.
- Connor, J., Bernstein, C., Kilgore, K., Rist, P., Osypiuk, K., Kowalski, , & Wayne., P (2020). Perceptions of Chiropractic Care Among Women With Migraine: A Qualitative Substudy Using a Grounded-Theory Framework. JMPT. https://linkinghub.elsevier.com/retrieve/pii/S0161475420301482 Accessed 28 April 2021