Counterfactual Corner: Migraine Research

Yoga for Migraine

What is your experience with exercise, in general, or yoga in particular? Do you have a routine that works well during a migraine attack? Do you find it helps prevent attacks or abort attacks?⁣⁣

In a recent randomized trial, results showed that yoga plus medication was a superior treatment to medication alone for episodic migraine.⁣⁣

The study randomly assigned 114 adults with episodic migraine (between 4 and 14 attacks per month) to two groups (in a 1:1 ratio): one that received preventive medication only and a second that received preventive medication plus yoga.⁣⁣

The yoga plus medication group learned a one-hour routine during three teacher-led sessions per week over the course of one month, then continued at home with five weekly sessions for two more months. Both groups completed diaries of symptoms, symptom location, triggers, and acute medication use. Monthly check-ins were made to assess progress.⁣⁣

The results showed that both groups had a reduction in frequency and intensity of headaches. However, the yoga plus preventive medication group had fewer headaches, less intense headaches, lower HIT scores (a measure of headache severity), headache disability (MIDAS score), and used fewer acute medications than their preventive medication-only peers.⁣⁣

I don’t have full access to the study, but the design seems relatively rigorous. One concern: it is hard to double-blind studies of alternative therapies, so there is a concern that people in the yoga plus medication group knew they were receiving the treatment and this created a sort of positive “performance bias.”

Future studies could explore the longer-term effects, as well as participants’ adherence over time. It was also conducted on people with episodic migraine, so the impact on those with chronic or intractable migraine might be different.⁣ Future studies could expand to include a chronic migraine sample.