Yoga for migraine: Does it work?
Incorporating yoga as a complementary therapy to standard pharmacological treatment for migraine helps reduce the frequency and intensity of migraine and its impact on the lives of people with such condition, according to the CONTAIN* study presented at the 2019 AHS Meeting.
As some patients remain unresponsive or intolerant to standard medical therapy, researchers have turned to complementary alternative medicine for potential solutions.
“Yoga based on the principles of mind-body medicine seems scientific and promising in this regard,” said the researchers.
CONTAIN is a study with a prospective randomized open blinded endpoint (PROBE) design which randomized 114 patients with migraine to undertake yoga intervention in addition to medication or medication alone. The add-on yoga group underwent a predesigned yoga module led by a trained yoga instructor for 1 month, and were subsequently instructed to follow the same training at home for 2 months. [AHS 2019, abstract P08]
Patients who participated in yoga experienced a greater reduction in migraine frequency compared with those in the medication alone group (mean reduction, 9.3 vs 3.1 days/month; p=0.005), despite the yoga group having more frequent headache at baseline (9.07 vs 7.7 days/month; p=0.012).
Improvements in the coprimary endpoints of headache intensity (8.3 vs 4.6; p=0.002) and quality of life indicated by the HIT** score (66.9 vs 49.0; p=0.009) were also greater in the add-on yoga group vs the medication alone group.
Similarly, add-on yoga led to a greater functional improvement with regard to headache-related disability, as assessed on the MIDAS*** (24.6 vs 7.5; p=0.000) compared with medication alone.
Patients who participated in yoga required less rescue medications than the medication alone group (reduction in pill count, 7.1 vs 2.7; p=0.000). In keeping with this, significantly more patients in the yoga group were free of headache at the end of 3 months compared with the medication alone group (12.28 percent vs 0 percent).
The researchers pointed out that not only was the integration of yoga therapy to complement standard medical therapy effective, it was also safe in patients with migraine.
“Based on the results of this study, yoga should be recommended to migraine patients in addition to their standard pharmacotherapy for optimizing clinical improvement and reducing disability,” the researchers said.
Although it is not yet clear how yoga improves migraine, a previous study with similar findings in migraine patients showed that yoga enhanced the vagal tone (ie, activity of the vagus nerve), which is a fundamental component of the parasympathetic autonomic nervous system (PNS). [Int J Yoga 2014;7:126-132] Activation of the PNS can lower the heart rate and blood pressure, a manifestation of relaxation response that can help combat stress and relax the body and mind.