An estimated 59 million people in the United States spend a collective $30.2 billion dollars on complementary and integrative medicine annually.1 Approximately half of the 14% of Americans who have severe headache and migraine report having tried interventions such as meditation, yoga, and deep breathing exercises.2,3
Despite this high prevalence, many patients do not disclose to their healthcare providers that they use such interventions, and many clinicians are unfamiliar with these approaches and the mechanisms underlying their effectiveness. A review published in February 2019 in Current Pain and Headache Reports noted that nearly 85% of providers did not feel adequately informed to advise patients on complementary medicine interventions.4
With the aim of increasing providers’ comfort level in discussing such approaches with patients, researchers from Wake Forest Baptist Health in Winston-Salem, North Carolina, examined studies published between 2015 and 2018 in which complementary and integrative medicine interventions used for migraine treatment, either as monotherapy or in combination with other modalities, were examined.4 Selected findings by intervention type are highlighted below.
Mind/body therapies. In a 2015 study of 37 patients with chronic migraine or tension-type headache, an 8-week mindfulness-based stress reduction (MBSR) program, when combined with pharmacotherapy vs medication alone, was associated with improved pain intensity and quality of life (assessed with a headache log and short-form 36 questionnaire, respectively).5
In a 2018 study in a similar patient group, MBSR was associated with improvements in disability (P <.0001), mindfulness (P <.001), distress (P <.0001), and the emotional dimension of pain (P <.0001), as evaluated with the Migraine Disability Assessment; the Freiburg Mindfulness Inventory; the Depression, Anxiety, and Stress Scale; and the McGill Short Form Questionnaire, respectively.4
Another study examined the effects of a mindfulness intervention compared with medication after a 5-day outpatient day program for medication overuse in chronic migraine.4 The results indicate similar reductions between groups in headache frequency (by 6-8 days per month), medication use, and Migraine Disability Assessment scores.