Massage for migraine

Can regular massage help manage migraine?

Relaxing music, aromatic oils, warm towels, dim lights and therapeutic muscle manipulation – these are the essence of a massage treatment. It sounds good, smells good, feels good – but can it help with migraine?

There hasn’t been a lot of research on massage for migraine, but there was one in New Zealand in 2003. I was a participant in this study. Eligible people were randomised to either weekly massage for six weeks or just carrying on life as usual. I was in the carry on as usual group, and carried on for so long that it was only in 2022 that I came across the results of the study. It found that those who got the massages had better sleep quality and fewer migraine attacks.

The problem with this study, and others like it, was that it was pretty small (only 44 people in the final analysis). The problem with studies about massage in general is that there are so many different types of massage, so how do we know which is best? The New Zealand study focused on trigger points and myofascial release, based on the idea that reduced muscle tension promotes relaxation, diminishes stress responses and may help with sleep.

It makes sense that massage could help reduce the frequency and severity of migraine, given that stress and poor sleep can provoke attacks. Researchers and clinicians want more and higher quality studies before they recommend massage as a first line therapy, but given the very low risk of harm from massage, I don’t see lack of research as a barrier to encouraging people to give it a go. The main barrier for me is the cost. So maybe we need the high quality studies to convince funders that massage for migraine is worth subsidising, as a treatment with far fewer side effects than most medications we use for migraine prevention, and maybe even as effective.

Imagine that instead of getting a prescription for propranolol or amitriptyline, we could get a voucher from our doctor, redeemable for a weekly therapeutic massage. It might cost more, but it would feel so much better.

Dr Fiona Imlach, Migraine Foundation Aotearoa New Zealand co-founder

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