ARTICLE
In an article entitled Integrating Chiropractic Care Into the Treatment of Migraine Headaches in a Tertiary Care Hospital: A Case Series the National Centers for Biotechnology Information (NCBI) reports “Chiropractors are licensed to administer nonsurgical and nonpharmacological therapies for health restoration and maintenance. … The goals of therapy are to optimize neuromusculoskeletal health and reduce the patient’s overall pain burden.” Patients in this study were treated in this case series received full scope of practice care. The mechanisms through which chiropractic treatment may influence migraine headache expression remains unclear and is likely multifold considering the multipronged approach taken. For example, reducing muscle tension and correcting postural strain on soft tissues may lessen the overall musculoskeletal pain, and spinal manipulative therapy is theorized to activate descending pain inhibitory pathways responsible for pain modulation. Several small studies have suggested that spinal manipulation may be an effective treatment for reducing migraine pain and disability. This study performed a systematic review and meta-analysis of published randomized clinical trials (RCTs) to evaluate the evidence regarding spinal manipulation as an alternative or integrative therapy in reducing migraine pain and disability. This study concludes that spinal manipulation may be an effective therapeutic technique to reduce migraine days and pain/intensity. Methodologically rigorous, large-scale RCTs are warranted to better inform the evidence base for spinal manipulation as a treatment for migraine. PubMed and the Cochrane Library databases were searched for clinical trials that evaluated spinal manipulation and migraine-related outcomes through April 2017. Search terms included: migraine, spinal manipulation, manual therapy, chiropractic, and osteopathic. Meta-analytic methods were employed to estimate the effect sizes and heterogeneity for migraine days, pain, and disability. The methodological quality of retrieved studies was examined following the Cochrane Risk of Bias Tool. Researchers identified 6 RCTs eligible for meta-analysis. Intervention duration ranged from 2 to 6 months; outcomes included measures of migraine days (primary outcome), migraine pain/intensity, and migraine disability. Methodological quality varied across the studies. Due to high levels of heterogeneity when all 6 studies were included in the meta-analysis, the 1 RCT performed only among chronic migraineurs was excluded. We observed that spinal manipulation reduced migraine days with an overall small effect size as well as migraine pain/intensity. Additional body systems include the respiratory, digestive and circulatory system and the immune systems. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440032/