Migraine responds better to a combination of medical therapy and trigger point management than routine medical therapy alone

NeuroRehabilitation. 2015;37(1):157-63. doi: 10.3233/NRE-151248.


Background: Migraine is one of the most frequent headaches. Cervical myofascial and trigger point disorders are effective factors on accession of this type of headache. PRT is an indirect technique that treats trigger points.

Objective: The purpose of this study was to compare the effectiveness of trigger points' management by positional release therapy (PRT) combined with routine medical therapy and routine medical therapy alone in treatment of migraine headache.

Methods: Forty-four patients with active trigger points in cervical muscles entered to the study. They were randomly assigned to PRT-medical therapy or medical therapy group. Headache frequency, intensity, duration and tablet count were recorded by use of a daily headache diary. The sensitivity of trigger points was assessed by the use of a digital force gauge (Wagner-FDIX). Cervical range of motion was measured by a goniometer.

Results: Both groups showed significant reduction in headache intensity, frequency, duration and tablet count after 4 months follow up. The sensitivity of trigger points and all cervical range of motions significantly increased in PRT-medical group after 4 months follow up; however in medication group except cervical right lateral flexion, right and left rotation the other factors showed no change after 4 months follow up. In comparison of the two study groups, there was no significant difference in headache-related variables. Apart from the headache intensity and tablet count, the trends of other factors were significantly different between the two groups (p < 0.05).

Conclusions: The combined PRT-medical therapy is more effective than the medical therapy alone. Thus, the combination of PRT and medical therapy is suggested as a treatment choice for patients with migraine headache.

Keywords: Migraine headache; positional release therapy; trigger point.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Combined Modality Therapy / methods
  • Humans
  • Migraine Disorders / drug therapy
  • Migraine Disorders / therapy*
  • Musculoskeletal Manipulations / methods*
  • Trigger Points / physiopathology*


  • Anti-Inflammatory Agents, Non-Steroidal
  • Antihypertensive Agents