The efficacy of acupuncture combined with chiropractic manipulative therapy in the management of migraines
The aim of this investigation was to determine the relative effect of two treatments for migraine headache. It was hypothesised that by combining chiropractic adjustments with acupuncture, there would be a greater effect as opposed to using chiropractic adjustments only. Thirty subjects diagnosed as having migraine headaches were randomly divided into two treatment groups. Each group consisted of 15 subjects, between the ages of 20 and 59, selected from the general population. The first group received chiropractic adjustment with acupuncture, whilst the second group received chiropractic adjustment only. The research project was carried out where both groups received 10 treatments over a period of four weeks. After a follow-up period of eight weeks, the patients were reassessed. Subjective and objective measurements of the cervical spine using the Cervical Range of Motion (CROM) goniometer and completion of Canadian Memorial Chiropractic College (CMCC) neck disability index and McGill Short Farm questionnaire were performed before the first, fifth and to' treatment and at the last follow-up assessment Headaches were recorded in a headache diary at intervals of four weeks over a period of twelve weeks. Following this, the data was then analysed statistically using a 95% confidence level. Intra-group comparisons were done using the Wilcoxon signed rank test. Inter-group comparisons were done using the Mann-Whitney U-test. Inter-group comparisons indicated that neither group improved statistically significantly more than the other. (p>O.05). Intra-group results indicated that the adjustment group improved statistically significantly in terms of frequency, duration, and intensity and also with regard to the eMee and the McGill Short Form questionnaires (p<O.05). Intra-group results for the adjustment and acupuncture group indicated statistically significant findings for only headache intensity and the McGill short form questionnaires (p<O.05). There were no statistically significant changes with regards to the CROM readings for both Inter and Intra-group analyses for either of the treatment groups. From these results, it would seem that the adjustment group performed better than the adjustment and acupuncture group in terms of subjective findings. However, the inter-group analysis indicated this was not the case and it therefore could not be inferred that the adjustment group responded more favourably than the adjustment with acupuncture group in the treatment of migraine headaches. It is suggested that further studies with a larger sample size are needed together with a placebo and/or control group to clearly evaluate the use of combined adjustment with acupuncture. It was also suggested that any future studies study the effects of combined adjustment with acupuncture on specific types of migraine. With regard to acupuncture treatment, it is recommended that different points be tried for migraine headache and furthermore different points for different symptom pictures of migraine be used.