A pre-test, post-test intervention study (with embedded waiting list control) to assess the feasibility (efficacy; acceptability; and methodology) of mobilization of C0-C3 cervical segments to reduce headache in migaineurs

Abstract

Background Migraine headache poses a major public health problem. Pharmacological treatment is the most common management strategy, however patients increasingly seek alternative treatments. The Watson Headache® Approach, (targeted and sustained, non-manipulative mobilization on C0-3) is used to reduce headache symptoms and provide sustained relief. The aims of this research were to assess this approach as a treatment strategy for migraine headache and to provide data to inform a subsequent randomized controlled trial. Methods One-hundred and one migraineurs were randomised to either ‘Treat Now’ (n=54) or ‘Waiting List’ (n=47) groups. Physiotherapists trained in the approach provided the intervention and participants received six sessions. Outcome data was collected as a headache diary, including: Headache Score, headache days, headache duration, pain and medication use. Follow up was at post treatment (FU0), 3 months (FU3), 6 months (FU6) and 12 months (FU12). Results For the between group analysis, no difference was found between the ‘Waiting List’ group at Baseline 2 compared with the “Treat Now” group at FU0 for any of the variables of interest. For the within group analysis, post treatment, participants experienced a reduction in headache intensity (p=0.27), fewer headache days/28days (p<0.001), shorter headache durations (p<0.001) and 20% fewer medications used compared with pre-treatment (p<0.001). Conclusion The Watson Headache® Approach shows promise as a potential strategy for migraine management, however further work is required to assess the efficacy of this technique in a larger, placebo controlled randomized controlled trial Future studies should aim to identify those most likely to benefit from treatment and who may be at risk of potential side-effects.