Migrain and neck pain: Effectiveness of non-pharmacological treatment

Abstract

Objective: Comorbidities and co-occurring conditions contribute to the overall burden of migraine. Treatment co-occurring condition is an important part in providing optimal care. Aim: To investigate the effectiveness of complex non-pharmacological treatment episodic migraine and co-occurring neck pain. Methods: We evaluated 77 patients, age from 18 to 55: group I with episodic migraine - 42 (with aura 8 and 34 without aura) and co-existing neck pain (m/f: 6/36) and group ІІ with cervicogenic headache – 35(m/f: 12/23). Radiography of the cervical spine, VAS, "HIT-6", NDI and serum level of CGRP was by enzyme-linked immunosorbent assay ELISA principle were assessment. All patients had non-drug treatment of neck pain, which included manual methods and acupuncture, and individually selected therapeutic physical exercises. The Kolmogorov-Smirnov test was used to compare the data. Results: Plasma level of CGRP was significantly higher in patients with episodic migraine with neck pain 242,98±5,08 пг/мл compared with the group with cervicalgia without migraine 51,96±4,46 пг/мл (p = 0.012543). The result of the treatment was decrease of tension in pericranial muscles: NDI (І: 4,43±0,26, р<0,05; 5,31±0,22, р<0,05). There was a significant reduction in headache intensity: VAS І: 6,93±0,11, р<0,05; ІІ: 2,34±0,15, р<0,05). Frequency of headache attacks within 4 weeks has significantly decreased in both groups (І: 2,59±0,13, р<0,05; ІІ: 2,09±0,14, р<0,05), number of days with headaches within 4 weeks has gone down (І: 4,71±0,29, р<0,05; ІІ: 2,31±0,16, р<0,05) as well as number of days with simple and combined analgesics (І: 2,33±0,36, р<0,05; ІІ: 1,09±0,22, р<0,0006). Conclusion: Non-pharmacological treatment neck-pain in patients with episodic migraine to be effective in control of pericranial muscles tension and influence on decrease of frequency and severity migraine attacks, more significant reduce pain syndrome and psychological disorders that lead to reduce drug intake.