Assessing the feasibility of mobilisation of C0–C3 cervical segments to reduce headache in migraineurs

Background: Migraine headache poses a major public health problem. Pharmacological treatment is the most common management strategy, however patients are increasingly seeking alternative treatments. The Watson Headache® Approach (targeted and sustained non-manipulative mobilisation on C0–C3) is used to reduce headache symptoms and provide sustained relief. This research aimed to assess this approach as a treatment strategy for migraine headache and to provide data to inform a subsequent randomised controlled trial. Methods: One-hundred-and-one migraineurs were randomised to either the ‘treat now’ (n=54) or ‘wait list’ (n=47) group. Physiotherapists trained in the approach provided the intervention. Participants received six sessions. Outcome data were collected as a headache diary, including: headache score, headache days, headache duration, pain and medication use. Follow up was immediately post treatment (FU0) and at 3 (FU3), 6 (FU6) and 12 months (FU12). Results: Between-group analysis found no difference between the wait list group at baseline 2 and the treat now group at FU0 for any of the variables of interest. Within-group analysis found that after treatment participants experienced a reduction in headache intensity (P=0.007) and duration (P<0.001), had fewer headache days/28 days (P<0.001), hours of severe migraine headache (P<0.001) and used 20% fewer medications compared with before treatment (P<0.001). Conclusion: The Watson Headache® Approach shows promise as a potential strategy for migraine management, however further work is required to assess the efficacy of this technique in a larger, randomised placebo-controlled trial. Future studies should aim to identify those most likely to benefit from treatment and who may be at risk of potential adverse event.