A treatment program for migraine sufferers that includes exercise and relaxation therapies is more effective than conventional treatment alone, according to a study in Headache (2002;42:845–54).
Migraine is a disorder characterized by episodes of severe headaches, nausea, vomiting, and light and sound sensitivity. An estimated 30 million people in the United States suffer from migraines. This high prevalence and the significant disability associated with migraines make finding acceptable and affordable treatment a high priority.
Conventional treatment focuses on drug therapies, including nonprescription and prescription pain relievers, and medications designed to interrupt the biochemical processes that cause migraines. Most of these medications relieve migraine by restricting blood flow to the head, but their effects on blood vessels in other parts of the body can be problematic, particularly in people with heart and blood vessel diseases, people using other medications that affect blood flow, and pregnant and breast-feeding women. It is possible to become dependent on some of these medications. Furthermore, long-term frequent use of any of these medicines can result in additional headaches, known as medication overuse headaches, which are far more difficult to treat than common migraines. For these reasons, more than half of people who suffer from migraines stop seeking medical care for their headaches.
In the current study, 80 participants with migraines were randomly assigned to receive either a six-week comprehensive treatment program or standard medical care from family practice physicians. Standard medical care in this study included medications, referrals to other providers, or no treatment, while comprehensive treatment included drug therapies as needed along with exercise and relaxation therapies, two relaxing massages, and a lecture on diet. Participants were evaluated for pain and disability, quality of life, and medication use at the end of the six-week treatment period and three months later.
Pain frequency, intensity, and duration all decreased significantly after six weeks in the group receiving the comprehensive treatment program but increased slightly in the group receiving only medical treatment. In addition, the comprehensive treatment group rated their ability to function as improved by nearly 35% and their overall quality of life as improved by more than 35%, while the conventional treatment group reported slight reductions in their ability to function and in their quality of life. The improvements noted by the comprehensive treatment group were even more significant at the three-month evaluation, with ability to function increased by 51% and quality of life by 57%. Individuals who continued with their exercise program had more improvement than those who did not.
Studies over the past 30 years have consistently found that behavioral therapies, primarily relaxation training and stress reduction, effectively reduce migraine and another type of headache known as tension headache. A review of these studies revealed that behavioral therapies consistently reduced migraine and tension headaches between 35% and 50%. Few studies, however, have compared behavioral therapies with conventional treatment. One such study found that the combination of behavioral and drug therapies was more effective than drug therapies alone in treating medication overuse headache. The current study shows that a comprehensive treatment program is also a better approach for treating uncomplicated migraine. Furthermore, participants in this study found that exercise therapy was the most important aspect of their treatment.
Dietary approaches, such as limiting foods high in the amino acid tyramine and identifying and avoiding allergenic foods, are helpful for some people with migraines. Although participants in the comprehensive treatment group were given a lecture on diet, the authors did not describe the type of dietary advice given, and did not attribute the reduction in migraines to any specific dietary changes.
Other natural approaches to preventing and treating migraines include supplementing with nutrients such as magnesium, riboflavin, and coenzyme Q10. The herb feverfew has also been shown to reduce the recurrence rate of migraines.
