Potential Add-On Effects of Manual Therapy Techniques in Migraine Patients: A Randomised Controlled Trial.

Objective : To ascertain whether the combination of soft tissue and articulatory manual techniques is more effective than either one of these techniques alone for reducing migraine impact; Methods : Seventy-five participants with migraine were randomly divided into three groups ( n = 25 per group): (i) soft tissue (STG), (ii) articulatory (AG), and (iii) combined treatment (STAG). Pain, frequency of occurrence, duration, disability and impact, depression and anxiety levels, and perception of change were analysed at baseline, post intervention (T2) and at four-week follow-up (T3); Results : STAG showed a significantly greater reduction in pain versus STG and AG at T2 ( p < 0.001; p = 0.014) and at T3 ( p < 0.001; p = 0.01). Furthermore, STAG achieved a significantly greater reduction in pain duration versus STG at T2 ( p = 0.020) and T3 ( p = 0.026) and a greater impression of change versus STG ( p = 0.004) and AG ( p = 0.037) at T3. Similar effects were observed in all groups for frequency of occurrence, migraine disability, impact, and depression and anxiety levels; Conclusions : A combined manual therapy protocol including soft tissue and articulatory techniques yields larger improvements on pain and perception of change than either technique alone, yet the three therapeutic approaches show similar benefits for reducing pain, disability and impact caused by the migraine, depression or anxiety levels.