Multi-Segmental Spinal Manual Therapy in Women With Episodic Migraine

Multi-segmental Spinal Manual Therapy for Pain, Central Sensitization, and Sensorimotor Control in Women With Episodic Migraine: A Case Series.

The purpose of this study is to evaluate the clinical effects of multi-segmental spinal manual therapy on pain intensity, central sensitization (CS), and sensorimotor control in women diagnosed with episodic migraine (EM).

Participants receive 10 sessions of a comprehensive manual therapy intervention targeting the cervical, thoracic, lumbar, and sacral regions over a 2-week period. Clinical outcomes-including headache pain intensity, sensorimotor dysfunction, headache-related disability, and cutaneous allodynia-are evaluated at baseline, immediately after the 2-week treatment, and at a 1-month follow-up.

This study aims to investigate whether addressing multiple spinal segments with manual therapy improves clinical symptoms, spinal motor control, and central pain processing in female individuals with EM.

Inclusion Criteria:

• Female patients aged 18-30 years,
• Diagnosis of episodic migraine established by a specialist neurologist,
• Headache frequency of <15 days per month,
• Pain intensity score of ≥40 mm on the Visual Analog Scale (VAS),
• Absence of any diagnosed psychiatric disorders,
• Literacy (ability to read and write),
• Ability to communicate effectively without language or cognitive barriers,
• Voluntary participation confirmed by signed written informed consent.

Exclusion Criteria:

• History of communication disorders or neuromusculoskeletal diseases that impede assessment procedures,
• Headache frequency exceeding 15 days per month,
• Diagnosis of other primary or secondary headache types (e.g., cervicogenic headache, tension-type headache),
• Pregnancy,
• Diagnosis of fibromyalgia syndrome or myofascial pain syndrome,
• Diagnosis of systemic rheumatic diseases (e.g., rheumatoid arthritis, systemic lupus erythematosus),
• Diagnosis or presence of symptoms related to spinal disc disorders (e.g., disc herniation, disc prolapse),
• History of whiplash or similar cervical/head trauma,
• Diagnosis or presence of symptoms associated with temporomandibular joint dysfunction (TMD),
• Having received physical therapy within the last 3 months,
• Having undergone anesthetic nerve block procedures within the last 6 months,
• Receiving any prophylactic or interventional migraine therapy other than acute analgesics,
• Self-reported history or presence of malignancy.