Migraine is a neurological disease that can be severely debilitating and is the second leading cause of disability worldwide. Unfortunately, many patients with migraine discontinue medications due to ineffectiveness or side effects. Many patients still use opioids despite recommendations against them for headache treatment. However, in a recent clinical trial from Wake Forest Baptist Health, researchers showed that mindfulness-based stress reduction (MBSR) may provide benefit to people with migraine.
Mindfulness-based stress reduction is a mind-body treatment that teaches moment-by-moment awareness through mindfulness meditation and yoga. Mindfulness can also teach new ways to respond to stress, a commonly reported migraine trigger."
Rebecca Erwin Wells, M.D., M.P.H., Associate Professor of Neurology, Wake Forest School of Medicine, part of Wake Forest Baptist Health
According to an article published by JAMA Internal Medicine, researchers studied whether MBSR improved migraine outcomes, pain perception and measures of emotional well-being compared to headache education.
In the study, 89 adults with a history of migraine were randomly assigned to either the MBSR group or headache education group with training or instruction delivered in eight weekly two-hour sessions.
The MBSR group followed a standardized curriculum of mindfulness meditation and yoga. Participants also received electronic audio files for home practice and were encouraged to practice at home 30 minutes a day. The headache education group received instruction on headaches, pathophysiology, triggers, stress and treatment approaches.
Participants in both the MBSR and headache education groups reported fewer days with migraine. However, only MBSR also lessened disability and improved quality of life, depression scores and other measures reflecting emotional well-being, with effects seen out to 36 weeks. Further, experimentally induced pain intensity and unpleasantness decreased in the MBSR group compared to the headache education group, suggesting a shift in pain appraisal.
"At a time when opioids are still being used for migraine, finding safe non-drug options with long-term benefit has significant implications," said Wells, who is also the founder and director of the Comprehensive Headache Program at Wake Forest Baptist. "Mindfulness may treat the total burden of migraine and could potentially decrease the impact of this debilitating condition. A larger, more definitive study is needed to confirm these findings."
Wells, R.E., et al. (2020) Effectiveness of Mindfulness Meditation vs Headache Education for Adults With Migraine. A Randomized Clinical Trial. JAMA Internal Medicine. doi.org/10.1001/jamainternmed.2020.7090.