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Original Post February 2017 | UPDATED JULY 26, 2020

Emerging best practice research never fails to teach us something new. And ChiroUp uses that data to keep each of your 100 management protocols up-to-date.

In fact, in the past 24 months, your ChiroUp protocol for Migraine Headache has been updated 21 times with game-changing research!

This blog highlights several current evidence-based conservative tools to help you manage migraine headaches more successfully.

Management of Migraine

 Migraine treatment is subdivided into “abortive” therapies that seek to stop or reverse the progression of an existing headache and “prophylactic” treatments, which seek to prevent or reduce the frequency of future attacks.  Abortive treatments are most effective when given within the first minutes of an attack.  (10) Unfortunately, once the migraine brain has been “triggered”, conservative therapy may not always abort that particular episode. However, prophylactic management directed at controlling migraine triggers is often helpful.

One of the best prophylactic tools is to maintain a “food diary” to help recognize and eliminate unique food triggers. Download this ChiroUp Food Trigger infographic to help your patients identify their prime suspects:

In addition to helping patients identify and eliminate food and lifestyle triggers, evidence-based chiropractors can offer a variety of effective tools including SMT, myofascial release, acupuncture, plus dietary and nutraceutical recommendations. An excellent 2015 literature review by Orr (15), provided recommendations for migraine prophylaxis, which ChiroUp has since condensed and updated with the latest research. Here are our current top ten:

1. Manual Therapy

Spinal manipulation is a useful tool in migraine prophylaxis. One study demonstrated a “significant reduction” of migraine intensity in almost half of those patients receiving spinal manipulation.  Nearly ¼ of migraine patients reported greater than 90% fewer attacks.  (11) Spinal manipulation has demonstrated similar effectiveness but longer-lasting benefit with fewer side effects when compared to a well-known and efficacious medical treatment (amitriptyline).  (11,12,13,14)

A Harvard study found that SMT significantly reduced migraine days as well as pain intensity. (52) And SMT is safe; a study to define adverse events following chiropractic spinal manipulation for migraines found that “adverse events were mild and transient, and severe or serious adverse events were not observed.” (53) 

Several recent studies have shown that acupuncture is another viable tool for managing migraines. (49-51,59,60)

2. Eat Smart & Maintain an Ideal Weight

Dietary fats trigger the synthesis of prostaglandins which are known migraine triggers (19). Low-fat diets have been shown to play a role in migraine prophylaxis. (20,21) Weight loss may decrease the frequency of migraine and other primary headaches (tension, cluster). (16-18)  Patients on a low sodium (DASH) diet report a decrease in headache frequency vs those on a high sodium diet.  (23) One new study showed that “adherence to the Harvard Healthy Eating Plate advice, particularly the reduction in carb, red and processed meat consumption, is useful in migraine management, reducing migraine frequency and disability.” (47)

3. Drink Water

Increased hydration may produce subjective improvement in headache disability and intensity. (22) A study published earlier this month, showed “The results showed that the severity of migraine disability pain severity headaches frequency and duration of headaches were significantly lower in those who consumed more total water.” (48)

4. Vitamin D

Vitamin D deficiency is associated with migraine attacks. (54,55) Vitamin D supplementation in a dose of 1000-4000 IU/d has been shown to reduce the frequency of migraine attacks. (55-57)

5. B Vitamins

Riboflavin (Vit B2) may help prevent migraines. (26, 29-38) Dosage recommendations vary, however, the average dose used in the studies was 400mg/day. Vitamin B6 supplementation (with or without concurrent B9 and B12) has also demonstrated prophylactic benefit. (58) 

6. Feverfew (125mg)

Feverfew may be a useful tool for preventing migraines. (24,25,26) Dosage recommendations vary, however, the average dose used in the studies was 125mg/day. 

7. Ginger

Adding ginger to feverfew may provide relief for acute migraine. (27,28) The proprietary ginger preparation used was (LipiGesicM™ )

8. Magnesium (400-600mg)

Magnesium may provide migraine prophylaxis. (26, 39-42) An umbrella review found strong evidence that “Magnesium supplementation can reduce the intensity/frequency of migraine.” (61) Dosage recommendations vary, however, the average dose used in the studies is 400-600mg/ day for the prevention of migraine in non-pregnant patients.

9. Coenzyme Q10 (100mg TID)

Coenzyme Q10 may be effective in migraine prophylaxis. (26, 43-46) Dosage recommendations vary, however, the average dose used in the studies was 100mg TID.

10. Melatonin (2-3mg)

One systematic review and meta-analysis concluded: “Melatonin may be of potential benefit in the treatment‐prevention of migraine in adults.” (62) Study doses varied widely (0.05-50mg), however, the typical dose used in the studies was 2-3mg, taken before bedtime.

Now it’s time to put that research into action! Visit our website to learn more about how ChiroUp makes it easier than ever to apply best practices & educate your patients.

References
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About the Author

Dr. Tim Bertelsman

Dr. Tim Bertelsman

DC, CCSP, DACO

Dr. Tim Bertelsman graduated with honors from Logan College of Chiropractic and has been practicing in Belleville, IL since 1992. He has lectured nationally on various clinical and business topics and has been published extensively. He has served in several leadership positions within the Illinois Chiropractic Society and currently serves as past president of the executive board.

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