title: A randomized controlled trial of chiropractic spinal manipulative therapy for migraine.
abstract: OBJECTIVE
  To assess the efficacy of chiropractic spinal manipulative therapy (SMT) in the treatment of migraine.
  
  
  METHODS
  A randomized controlled trial of 6 months' duration. The trial consisted of 3 stages: 2 months of data collection (before treatment), 2 months of treatment, and a further 2 months of data collection (after treatment). Comparison of outcomes to the initial baseline factors was made at the end of the 6 months for both an SMT group and a control group.
  
  
  METHODS
  Chiropractic Research Center of Macquarie University.
  
  
  METHODS
  One hundred twenty-seven volunteers between the ages of 10 and 70 years were recruited through media advertising. The diagnosis of migraine was made on the basis of the International Headache Society standard, with a minimum of at least one migraine per month.
  
  
  METHODS
  Two months of chiropractic SMT (diversified technique) at vertebral fixations determined by the practitioner (maximum of 16 treatments).
  
  
  METHODS
  Participants completed standard headache diaries during the entire trial noting the frequency, intensity (visual analogue score), duration, disability, associated symptoms, and use of medication for each migraine episode.
  
  
  RESULTS
  The average response of the treatment group (n = 83) showed statistically significant improvement in migraine frequency (P < .005), duration (P < .01), disability (P < .05), and medication use (P< .001) when compared with the control group (n = 40). Four persons failed to complete the trial because of a variety of causes, including change in residence, a motor vehicle accident, and increased migraine frequency. Expressed in other terms, 22% of participants reported more than a 90% reduction of migraines as a consequence of the 2 months of SMT. Approximately 50% more participants reported significant improvement in the morbidity of each episode.
  
  
  CONCLUSIONS
  The results of this study support previous results showing that some people report significant improvement in migraines after chiropractic SMT. A high percentage (>80%) of participants reported stress as a major factor for their migraines. It appears probable that chiropractic care has an effect on the physical conditions related to stress and that in these people the effects of the migraine are reduced.
authors.affiliation: Department of Chiropractic, Macquarie University, New South Wales, Australia.
authors.forename: P J
authors.initials: PJ
authors.lastname: Tuchin
authors.forename: H
authors.initials: H
authors.lastname: Pollard
authors.forename: R
authors.initials: R
authors.lastname: Bonello
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020393:Manipulation, Spinal / Q000379:methods*; D008875:Middle Aged; D008881:Migraine Disorders / Q000175:diagnosis / Q000534:rehabilitation*; D010147:Pain Measurement; D010865:Pilot Projects; D011336:Probability; D012016:Reference Values; D015203:Reproducibility of Results; D016896:Treatment Outcome