Effect of Different Physical Therapy Approaches in Management of Migraine Headache

Introduction: Migraine is a very common primary headache disorder with no underlying identifiable pathological cause. Migraine affects 11% of the total adult population creating a significant socio-economic burden on society. Transcranial Magnetic Stimulation (TMS) is a non-invasive tool alter the excitability of the cerebral cortex, and intracortical inhibitory circuits. It is a therapeutic modality that is being developed as both an acute and preventive treatment for migraine. Manipulative therapy is program of soft tissue manipulation, balancing the body s central nervous system with the musculoskeletal system. It is based on neurological laws that explain how the central nervous system initiates and maintains pain.Purpose: This study aimed to determine and to investigate effect of different physical therapy approaches in the management of migraine headache.Methods: Thirty migraine patients participated in the study, their aged from 20-50, assigned into three equal groups (G1, G2 G3). Treatment consisted of daily twelve low frequency (1Hz) rTMS sessions, delivered to the group one and three over occipital lope. Sham rTMS was used for the group two that is treated with manual therapy. Manual therapy also was delivered to G3. Pain intensity was measured with visual analogue scale before and after treatment.Results: Within each group: The G1 showed a statistical significant decrease in the mean value of VAS (p-value=0.005). Also in G2, the mean value of VAS was significantly decreased at post-treatment (p-value=0.005). The same findings were also recorded in G3, the mean value of VAS was decreased significantly (p-value=0.004).The percentage of improvement in VAS was nearly similar in groups 1, 2 and 3 (68.54%, 65.96% and 71.58% respectively).Conclusion: In light of the findings yielded from this study, we can conclude that low-frequency rTMS over occipital cortex is effective in improving migraine headache. But provided no additional benefit when compared to manipulative therapy alone, in the treatment of migraine headaches in adults.