Myofascial Examination Leads to Diagnosis and Successful Treatment of Migraine Headache

ABSTRACT

Objective: To evaluate the likelihood of reproducing a migraine patient's typical head pain with pressure on muscles and ligaments [the myofascial examination] and to evaluate the success of a home program of physical therapist supervised stretching of involved muscles along their lengths [PTS] in reducing the headache of migraine.

Methods: A pilot prospective observational study. Forty-nine consecutive migraine patients were classified and grouped by International Classification of Headache Disorders-II criteria. All patients with headaches reproduced by the myofascial exam were prescribed PTS. Patients estimated their global improvement by percentage. Improvement of the ICHD-II groups completing treatment was compared to that of groups declining treatment.

Results: The headaches of all patients having migraine without aura and chronic migraine and of five of 11 having migraine with aura were reproduced by the myofascial exam. For all migraineurs whose headaches could be reproduced by the myofascial exam the mean improvement of those having PTS was 68 percent. In the group that did not have PTS, mean improvement was 5 percent. In the group that had PTS, 88 percent had 50 percent or greater improvement. In the group that was offered PTS but did not have it, this rate was 10 percent

Conclusions: The myofascial examination of the head and neck reproduced the headache pain of most patients having migraine. The PTS is effective in treating these headaches. The myofascial examination should be used to determine treatment for migraineurs.

KEYWORDS. :

• Migraine with aura
• migraine without aura
• chronic migraine
• myofascial pain

ACKNOWLEDGEMENTS

Jane Leslie Garb performed statistical analysis of this paper. Allan Ropper, MD, provided critical comments on this paper's earlier forms, and Michael L. Rossen, MD, PhD, carried out statistical analysis and made critical comments on this paper.

Declaration of interest: The author reports no conflict of interest. The author alone is responsible for the content and writing of this paper.