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The Somatic Connection  |   October 2015
Osteopathic Manipulative Therapy Efficacious for Patients With Chronic Migraines
Author Notes
  • Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, California 
Article Information
The Somatic Connection   |   October 2015
Osteopathic Manipulative Therapy Efficacious for Patients With Chronic Migraines
The Journal of the American Osteopathic Association, October 2015, Vol. 115, 628. doi:10.7556/jaoa.2015.127
The Journal of the American Osteopathic Association, October 2015, Vol. 115, 628. doi:10.7556/jaoa.2015.127
Cerritelli F, Ginevri L, Messi G, et al. Clinical effectiveness of osteopathic treatment in chronic migraine: 3-armed randomized controlled trial [published online January 21, 2015]. Complement Ther Med. 2015;23(2):149-156. doi:10.1016/j.ctim.2015.01.011. 
In 2011, The Somatic Connection reported on a German clinical trial using osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) for patients with migraines.1 At the time the study was published, researchers recommended several possible next steps, including adding a sham intervention group and increasing the cohort size. This year, foreign-trained osteopaths who graduated from the Accademia Italiana Osteopatia Tradizionale in Pescara, Italy, in collaboration with local hospitals in Italy, reported on the largest randomized controlled trial of OMTh or sham therapy to treat patients with chronic migraines. 
In the reviewed study, 105 participants who had never undergone OMTh (36 men, 69 women, aged 18 to 60 years) were blindly sorted into 3 groups: (1) OMTh group: OMTh and medication (mean [SD] age; 36.9 [9.3] years); (2) sham group: sham therapy and medication (40.7 [8.7] years); and (3) control group: medication alone (38.4 [9.9] years). During a 6-month period, participants received either 8 OMTh or sham therapy sessions, depending on their group. The OMTh group received myofascial release, balanced ligamentous tension or balanced membranous tension, and craniaosacral therapy based on findings from osteopathic assessments. Sham therapy consisted of osteopathic examination and light manual contact. The primary outcome was measured by the Headache Impact Test, which is used to rate the impact of headaches on a participant’s daytime activities, taken at baseline and at 24 weeks. 
Results showed a statistically significant reduction in Headache Impact Test scores between the OMTh group compared with both the control (−8.40, −11.94, −4.86; P<.001) and sham therapy (−4.83, −8.36, −1.29; P<.001) groups. The sham therapy group did not demonstrate a statistically significant difference vs control. In addition, OMTh was effective compared with the sham therapy and control groups using several secondary outcome measures. No adverse effects were reported. The researchers provided both the OMTh and sham therapy interventions; however, participants who received the sham therapy were blinded to group allocation. 
Osteopathic manipulative therapy is effective at reducing symptoms and recurrence of migraines, in addition to reducing the amount of medication needed for patients to control symptoms. The researchers concluded that adjunct OMTh notably improved the quality of life of patients with migraines. This is the largest, most rigorous study completed to our knowledge and is important because the authors were able to replicate results of past studies. This study not only provides evidence on its own, but it also lends further credibility to the earlier work. 
References
Seffinger MA. Osteopathic manipulative therapy helps patients with migraines [The Somatic Connection]. J Am Osteopath Assoc. 2011; 111(10): 572-573.