Benefits of yoga for migraine

Adding yoga to a standard medication regimen is significantly better than medication alone in providing migraine relief, results of a randomized controlled trial show (Neurology. Published online May 6).

Findings from the largest trial of its kind to date showed patients with episodic migraine who added yoga to their standard medication regimen experienced a significantly greater reduction in migraine frequency and intensity.

The benefit was significantly higher in the yoga group in all areas, including headache frequency, pain, pain intensity, use of medications, and how much migraine interfered with the daily personal life or professional life

Migraine is one of the most common disabling primary headache disorders, affecting about 13% of people worldwide. The disorder can also have a marked impact on quality of life, causing patients to miss work and impair performance.

Furthermore, migraine is a risk factor for other disorders, including ischemic cerebrovascular disease, depression, and suicidality.

Although first-line therapy for patients with migraine is medication, only about half of patients with migraine experience a clinically meaningful response.

In addition, up to 10% of patients discontinue medication because of adverse events, and nearly one in two are reportedly dissatisfied with their current treatment.

For its part, yoga has been shown to have beneficial effects on various migraine measures, including frequency, intensity, and duration of pain.

To help tease out the potential effects of yoga as an adjuvant therapy in patients with episodic migraine, the researchers conducted a prospective, randomized, open-label superiority trial at a single center between April 2017 and August 2018.

In total, 160 patients with a diagnosis of episodic migraine between the ages of 18 and 50 were randomly assigned to either medical treatment alone or medical treatment with yoga.

Both groups also received counseling regarding lifestyle changes that may help with migraine, including the benefits of sleep, diet, and exercise. Patients in the yoga intervention group participated in a pre-designed yoga intervention, which they performed for 3 months.

Patients in the yoga group participated in three weekly 1-hour sessions at the institution for the first month, facilitated by a qualified yoga therapist.

This was followed by five weekly at-home sessions for the following 2 months. Participants received a booklet containing the details of the practice and maintained a yoga log. Compliance was ensured by twice-weekly calls from the yoga center to patients.

Patients also kept a headache log book, which included details about headache and medications. Headache severity was assessed via Visual Analogue Scale; the Migraine Disability Assessment questionnaire (MIDAS) and the Headache Impact Test (HIT)-6 were both used to document changes in headache-specific disability.

It total, 114 patients completed the trial, 57 in each group. Baseline characteristics were comparable between groups, except for a higher mean headache frequency among those in the yoga group.

At the 3-month follow-up, results shows that patients in the yoga group experienced greater improvements in every measure.

Headache frequency in the yoga group fell from an average of 9.1 per month to 4.7 per month at the end of the 3 months.

In comparison, those who received medication experienced an average decrease in headache frequency from 7.7 per month to 6.8 at the end of the 3 months.

Previous research has shown that yoga can significantly improve vagal tone, reduce sympathetic activity and also increase nitric oxide levels.

Other potential benefits of yoga for migraine patients include an increase in parasympathetic drive and suppression of the stress response systems. The practice may also reduce tension in the head, neck, shoulder, and temporal areas, and loosen the stiff muscles that may also trigger headaches.