Abstract
BackgroundWhile the clinical role of manual therapies in migraine management is unclear, the use of chiropractors for this condition is considerable. The aim of this study is to evaluate the prevalence and characteristics of chiropractors who frequently manage patients with migraine.MethodsA national cross-sectional survey of chiropractors collected information on practitioner characteristics, clinical management characteristics and practice settings. A secondary analysis was conducted on 1869 respondents who reported on their migraine caseload to determine the predictors associated with the frequent management of patients with migraine.ResultsA large proportion of chiropractors report having a high migraine caseload (HMC) (n = 990; 53.0%). The strongest factors predicting a chiropractor having a HMC include the frequent treatment of patients with axial neck pain (OR = 2.89; 95%CI: 1.18, 7.07), thoracic pain (referred/radicular) (OR = 2.52; 95%CI: 1.58, 3.21) and non-musculoskeletal disorders (OR = 3.06; 95%CI: 2.13, 4.39).ConclusionsSeveral practice-setting and clinical management characteristics are associated with chiropractors managing a HMC. These findings raise key questions about the therapeutic approach to chiropractic migraine management that deserves further examination. There is a need for more primary research to assess the approach to headache and migraine management provided by chiropractors and to understand the prevalence, burden and comorbidities associated with migraine found within chiropractic patient populations. This information is vital in helping to inform safe, effective and coordinated care for migraine sufferers within the wider health system.
Highlights
While the clinical role of manual therapies in migraine management is unclear, the use of chiropractors for this condition is considerable
The analyses presented in this paper were drawn from a questionnaire distributed during recruitment for a national practice-based research network (PBRN) titled the Australian Chiropractic Research Network (ACORN) project
Prevalence of migraine management Our study found a large proportion of Australian chiropractors report managing a high migraine caseload
Summary
While the clinical role of manual therapies in migraine management is unclear, the use of chiropractors for this condition is considerable. Indirect evidence suggests migraine pain has a peripheral origin whereby peripheral input from within cervical spine structures causes sensitization of trigeminal nociceptive pathways [7,8,9]. This may be more common in sufferers with neck pain and may involve convergent nociceptive input via the trigeminal nerve and the upper cervical afferents to the trigeminal cervical complex [10,11,12]. Interpretation of this indirect evidence may have implications for the role of manual therapies in the
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