Oscillating Mechanical Stimulation of the Craniocervical Region as Physical Therapy for Chronic Migraine: A Pilot Trial

Objective: We conducted a prospective trial of oscillating mechanical stimulation (OS) of the craniocervical region as treatment for drug-refractory chronic migraine (CM). Methods: Ten patients (8 women, 2 men; mean age 47.0 ± 15.1 years) were enrolled. The treatment was administered over an 8-week period to 13, 4, and 9 sites on the face and head, neck, and upper back, respectively, at 5- to 15-pound intensity. The primary outcome measure was the number of days patients suffered a migraine (hereafter “number of migraine days”), and the secondary outcome measures were the six-item Headache Impact Test (HIT-6) and Visual Analog Scale (VAS) scores for migraine pain intensity and the nine-item Patient Health Questionnaire (PHQ-9) and the seven-item Generalized Anxiety Disorder (GAD-7) scale scores. Results: Nine patients completed treatment. The number of migraine days remained unchanged, from a mean 21.7 ± 11.6 days/month before treatment to 19.3 ± 7.3 days/month upon completion of treatment. However, the HIT-6 scores improved from 67.0 ± 8.2 to 61.4 ± 7.1 (p = 0.007) after 3 weeks, 61.1 ± 11.5 (p = 0.01) after 6 weeks, and 59.9 ± 11.6 (p = 0.035) upon completion of treatment. Similarly, the VAS scores improved significantly from 7.3 ± 1.7 to 5.7 ± 3.1 (p = 0.018) at 6 weeks and 4.8 ± 2.8 (p = 0.011) upon completion of treatment. The GAD-7, PHQ-9, and allodynia scale scores remained unchanged. Conclusion: Our data suggest that OS is well tolerated and may become a feasible form of treatment for drug-resistant CM.