Yoga and Migraines

Effect of Yoga on Migraines

The origin of yoga practice began in India and dates back to 27000 BC. It is derived from the Sanskirt word “yuj,” which means “to join” or “to unite” and its practice is believed to promote physical and spiritual well-being of the human body. This practice is deeply rooted in mindfulness, involving the union of mind, body, and muscular activity with an emphasis on controlled, conscious breathing and self awareness. There are four basic principles that comprise yoga, referenced in Catherine Woodyard’s work on Exploring the therapeutic effects of yoga and its ability to increase quality of life, and is listed as the following:

1) The human body is a holistic entity comprised of various interrelated dimensions inseparable from one another and the health or illness of any one dimension affects the other dimensions.

2) Individuals and their needs are unique and therefore must be approached in a way that acknowledges this individuality and their practice must be tailored accordingly.

3) Yoga is self-empowering; the student is his or her own healer.

4)The quality and state of an individual’s mind is crucial to healing.

This 3,000 year old tradition has made its appearance in Western culture and according to the National Institute of Health, yoga is classified as a form of Complementary and Alternative Medicine (CAM). Yoga intertwines various physical posture positions, stretches, and breathing exercises, all of which have shown to be helpful in stress management and stress-related illnesses (stress may contribute to heart disease, cancer, stroke, and other chronic conditions). Practicing yoga regularly facilitates strength, endurance, and flexibility; spiritually, it may foster compassion, calmness, and self-control and can promote a sense of balance and union between the mind and body. In fact, there has been supporting evidence from several studies that show the correlation between yoga practice and its therapeutic benefits and improving quality of life, some of which include reduction in structural and physiological limitations, improvement in flexibility and mobility, promoting respiratory and cardiovascular activity, and a decrease in stress, anxiety, and depression.

Moreover, there have been specific studies that determine the effect of yoga as adjuvant therapy on individuals who suffer from migraines. A migraine’s clinical manifestations involve a hemi-cranial throbbing pain associated with nausea, vomiting, and light and sound sensitivity with or without transient neurological symptoms (dizziness, diplopia, dysarthria, dysphagia, and dystaxia/ataxia). To improve migraine management, the utilization of both pharmacological and non-pharmacological methods are critical, for instance, yoga. According to a 2014 study approved by the Institutional Ethical Committee, a total of 60 male and female patients between the ages of 15-60 years recruited from a tertiary referral neurology center were randomly separated in “group CC” which received conventional care (30 patients) while the remaining 30 patients received conventional care with yoga practice for 5 days a week for 6 weeks, “group Y.” Those who were recruited for the study must satisfy the IHS, ICHD-II criteria for migraine with or without aura and have a minimum 2 year history of migraine episodes ranging from 5-15 a month. To determine efficacy, autonomic function tests were performed at baseline and at the end of the intervention. In group CC, patients took note of their symptoms in a diary. One week after baseline assessment, telephone conversations were conducted to ensure that the diary is updated. The headache diary was then collected after 6 weeks post-intervention. On the other hand, in group Y, the patients were subjected to daily 1 hour yoga practice in addition to conventional treatment 5 days a week for 6 weeks (30 sessions total). A headache diary was also maintained, verified, and collected. Yoga was conducted under the practice of a trained yoga therapist and attendance and compliance were noted. Some of the practices performed in group Y include loosening and breathing exercises, awareness postures, neck flexion/extension, neck rotation, hand stretch breathing, and Sashankasana breathing.

To assess efficacy, a subjective assessment, Headache Impact Test (HIT-6), was performed to assess the quality of life of the patient based on the change in headache-related disability. In addition, subjective information regarding the number of headache episodes, intensity of headaches (from 0-10 on Visual analog scale), and medication use provided in the patient’s headache diary was observed. At the end of the 6th week, group CC and group Y rated the perceived benefit of therapy using a five point scale ranging from “greatly worsened my clinical condition” to “greatly improved my clinical condition.” They also assessed the therapy as “more harmful than helpful,” “neither harmful nor helpful,” or “more helpful than harmful.” Completion of the autonomic function test (ECG, breathing signals, heart rate variability (HRV)) was performed under head-ache free conditions at least 3 days before and after the test.

In conclusion, the result of this study showed significant reductions in monthly headache frequency, average pain intensity, and headache-related disability in both group Y and group CC. Group Y showed higher improvements in all clinical outcomes, such as more reduction in the frequency and intensity of headache (assessed via visual analog scale: 0 being no pain and 10 being worst pain) compared to group CC as evidenced by a baseline headache intensity of 9.30 ± 1.15 and 8.70 ± 1.26 in Group CC and Group Y respectively. After the end of 6 weeks, the headache intensity was 7.73 ± 1.23 in group CC and 2.03 ± 1.29 in group Y. Likewise, all patients in group Y and 73.3% patients in group CC admitted that therapy was more helpful than harmful, inferring that yoga intervention with conventional care has better improvement outcomes without any adverse effects.

Yoga is beneficial for stress management, and is helpful in the non-pharmacological adjunctive treatment of migraines as evidenced by this study. Moreover, this practice may be a critical therapy approach for chronic diseases exacerbated by stress, which include asthma, diabetes, arthritis, depression, and fibromyalgia. It is shown to reduce stress arousal patterns, reduce cortisol levels (a stress hormone), and provide autonomic stability. All in all, yoga with conventional care reduces migraine frequency and intensity and is safe and effective as adjuvant migraine therapy.

References

Kisan, Ravikiran, et al. “Effect of Yoga on Migraine: A Comprehensive Study Using Clinical Profile and Cardiac Autonomic Functions.” International Journal of Yoga, July 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4097897/.

Nayar, D, et al. “Role of Yoga as an Adjunct in the Management of Migraine Headache-Current Status and Future Indications.” International Journal of Yoga, Jan. 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9015090/.

Woodyard, Catherine. “Exploring the Therapeutic Effects of Yoga and Its Ability to Increase Quality of Life.” International Journal of Yoga, July 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3193654/#ref6.

Yoga:

Written by: Jae Chang and Hillary Pham

Yoga is the practice of physical poses that involves an individual to deeply focus on their concentration and breathing. Not only does it involve physical strength, but it also involves a lot of mental and spiritual strength as well. This practice originally was founded in India and quickly spread all across the globe. It is well loved by many as the outcomes of a yoga session is what people thrive for. Yoga is practiced by many as it helps to practice the mind, body and soul to be in control and still. It allows the body’s mind to find balance and peace within themselves. Yoga is not as simple as it may look. It requires a lot of concentration, trust, and endurance from the body.

Yoga is a great form of exercise that can be used for depression. The global annual incidence of major depressive disorder is around 3.0% and is a common and disabling mental disorder. Furthermore, elevated levels of depression that goes undetected without a formal diagnosis causes increased disability, reduced quality of life, and increased healthcare costs. Therefore, yoga may be a great way to alleviate some of these depressive disorders. Yoga has been seen in Indian philosophy and has been a part of traditional Indian spiritual practice for around 5000 years. Traditional yoga involves advice for ethical lifestyle, spiritual practice, physical activity, breathing exercises, and meditation. In the recent times, yoga has become a popular means to promote physical and mental well-being. However, traditionally, the ultimate goal of yoga was to unite the mind, body, and spirit. Regardless of the form of yoga, whether it is derivatives from North America or Europe, the difference between yoga and other forms of sports is the involvement and the focus of the mind instead of purely the body. Systemic reviews have shown that yoga can improve comorbid mental symptoms in physical conditions including cancer, menopausal symptoms, or pain. Moreover, it has shown to improve mental disorders like anxiety and perhaps schizophrenia. To understand how yoga is beneficial in patients with depression, knowing the background of depression is important. Depression is described as reflecting a primary disorder of biochemical and neurophysiological functions and altering monoamine metabolism can play a major role in the pathophysiology of depression. Studies have further demonstrated that central neurotransmitter such as GABA have been involved in depression. Interestingly, practicing yoga can increase dopamine and GABA levels. It can also increase the plasma serotonin levels in patients with depression. Hence, practicing yoga induces the increased release in some of the main neurotransmitter in the body. Another proposed mechanism is that yoga is able to decrease the dysregulation in the hypothalamic-pituitary-adrenal-axis, which is the stress response. In patients with depression, there is an increased level of plasma cortisol which is returned to normal levels after depression treatment. But overall, studies have found that yoga can reduce stress in healthy adults and decrease plasma cortisol levels in those with depression.

One study done by Ross et. al compared the practice of exercising with yoga. As we all know, exercise is almost always recommended by many physicians and doctors as it promotes overall health and wellbeing to an individual. And similarly, as mentioned, yoga helps to keep the mind and body at ease and in control during practice. So, this research team decided to compare both these practices, in order to see which practices provided the best overall health outcome and health conditions to an individual. The researchers found that when comparing yoga and exercise in regard to the total healthiness within an individual, yoga far suppressed that of exercise practices. The results found that yoga is much better at promoting an individual’s well-being of physical and mental health. In conclusion, Ross and his team concluded that the results proved his studies and research. However, Ross mentioned that the team would like to further expand on the study and focus on the chemical components of the body via the SNS/HPA axis to see if there are any effects found in that regard.

Yoga is a great form of exercise that has shown beneficial effects to the mind and the body. Although the chemical effects that can be seen from yoga is still unclear and needs further studies to determine with certainty, many evidence show that yoga nevertheless helps improve health and wellbeing.

References:

Ross, A., & Thomas, S. (2010). The health benefits of yoga and exercise: a review of comparison studies. The journal of alternative and complementary medicine, 16(1), 3-12.

Cramer H, Lauche R, Langhorst J, Dobos G. Yoga for depression: a systematic review and meta-analysis. Depress Anxiety. 2013 Nov;30(11):1068-83. doi: 10.1002/da.22166. Epub 2013 Aug 6. PMID: 23922209.

What is a Migraine? Migraines are often grouped in the same category as that of headaches. Migraine’s symptoms are more than that. It does have the throbbing pain effect just as a headache would for those who have experienced it but with a migraine, it might last for longer and it is often accompanied with symptoms of nausea. People who often experience migraines notice that they are sensitive to any movement, light, sound, as well as other actions. Any action might cause nausea, irritability, and more. There are many medications in the pharmaceutical industry that are able to treat the effects of migraines but there are also studies that show that migraines can be treated from an alternative medicine point-of-view.

Yoga. What do we know? Originally, yoga was used as a form of spiritual practice. Now, yoga became more popular and is used as a great form of alternative medicine which helps better our physical and mental well-being. Yoga has many great health benefits which includes relieving stress, improving mental and emotional health, relieving pain in the lower back and neck area as well as any tension-type pain which includes headaches and osteoarthritis specifically in the knee. Yoga helps people overall maintain great health habits. It is overall very beneficial in improving the quality of life.

What is the correlation between yoga and migraines? A study has shown that when patients suffering from migraines have implemented yoga practice as part of their routine, there was a decrease in headache frequency as well as its intensity. The study was on 60 patients that were both male and female migraine patients. The age group for the patients was between 15-60 years and it was with patients who experienced migraines for at least 2 years with a frequency of 5-15 episodes per month. The study occurred for 6 weeks and the 60 patients were divided into two even groups: one group that was treated with conventional care and another group that was also receiving conventional care but with an added 30 minutes of yoga sessions 5 days a week. Although, the study was performed on a significantly small number of patients, it was still shown that yoga had a significant effect on alleviating the frequency and intensity of headaches and migraines that have occurred.

Stress is a very common trigger for migraines to occur and yoga is a great practice to relieve stress. Activities such as yoga are a great practice to have in a person who experiences migraines and headaches. There are specific yoga postures that are shown to be more effective. Patients who decide to practice yoga should avoid the type of yoga that involves heat and postures with vigorous movement that might have a strain on the neck. There is a type of yoga that is shown to be effective in relieving stress in patients who experience migraines and headaches, it is called restorative yoga. Restorative Yoga focuses on breathing and meditation techniques which holding certain positions in a relaxed manner. Yoga is great as an additive treatment to the plan that a patient is already on. It will benefit by decreasing the overall frequency and intensity of a migraine or headache episode. It is important to speak with a doctor before implementing yoga in order to be in the class that is best fit for the patient’s well-being.

“Healthy Habits for Kids with Migraine: AMF.” American Migraine Foundation, 17 June 2020, americanmigrainefoundation.org/resource-library/kids-migraine-healthy-habits/.

Kisan, Ravikiran, et al. “Effect of Yoga on Migraine: A Comprehensive Study Using Clinical Profile and Cardiac Autonomic Functions.” International Journal of Yoga, Medknow Publications & Media Pvt Ltd, July 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4097897/.

“Yoga: What You Need To Know.” National Center for Complementary and Integrative Health, U.S. Department of Health and Human Services, www.nccih.nih.gov/health/yoga-what-you-need-to-know.

Migraines are one of the common headache disorders. Migraines can occur with or without aura and can last anywhere from 4 – 72 hours. Ache or pain is characteristically tightening or persistent in nature, of mild to moderate level of intensity, and bilateral in location, and affects regular physical activity. Photophobia, nausea, vomiting, and/or phonophobia often accompany the headache.

Physical movement relieves headaches by inhibiting the trigeminocephalocraniocervical sensory pathway (inflammation around this area land cranial nerve 5 causes migraines). Movement also improves local blood flow reducing muscle tone and decreases inflammation. Yoga therapy improves the dysfunctional hypothalamic–pituitary–adrenal system regulating the autonomic functions of the body decreasing headache frequency. Yoga is thought to work on promoting vagal modification by decreasing the effects of the angiotensin II and nitric oxide pathway. Angiotensin II pathway can block vagal activity in the cardiac muscle, so by incorporating exercise into a patient’s treatment regimen, it is believed to suppress angiotensin II. Nitric oxide can indirectly block effects from the sympathetic nervous system.

A study was conducted to assess the additive affect effect of yoga and physical therapy to improve quality of life and reduce headache frequency. “Headache frequency was found to be reduced significantly in all the three groups ( p < 0.005). However, patients undergoing physical therapy have an additional reduction in headache frequency compared with the other two groups ( p < 0.0001).” The total findings suggest that the addition of yoga therapy to the standard treatment leads to an additional improvement in patients with migraine. Physical therapy group patients showed a significant improvement in sensory and affective pain rating and VAS of SF-MPQ and HIT-6 score when compared within the group and when compared between all the three groups. A trial done in Brazil in 2015 recruiting 50 migraine patients suggested that physical therapy in the form of manual treatment for 50 minutes improves patient satisfaction by reducing migraine frequency. However, overall findings of the studies need to be confirmed by conducting a follow up with a larger patient population and more inclusive criteria such ad broader age groups.

References:

Mehta JN, Parikh S, Desai SD, Solanki RC, G Pathak A. Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine. J Neurosci Rural Pract. 2021;12(1):60-66. doi:10.1055/s-0040-1718842

Kisan R, Sujan M, Adoor M, et al. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions. Int J Yoga. 2014;7(2):126-132. doi:10.4103/0973-6131.133891

Migraines are chronic headaches that affect millions of people worldwide. They can last for hours or even days and can be classified with or without aura using the International Classification of Headache Disorders (ICHD-3). Although they are common, migraines can increase a person’s risk of developing cerebrovascular and cardiovascular diseases as well as cognitive impairments that may be triggered by stress. There have been reports of increased suicidal risk for patients with migraines especially if they are being left untreated. Normally, patients can experience a bilateral tightening pain sensation that be extreme enough to affect a person’s daily living. The painful headaches are also accompanied with photophobia, nausea, or vomiting caused by the autonomic nervous system. There are several different reasons as to why migraines can occur. Certain triggers such as hormones, foods, environment, and stress can play a role in the development of a migraine. Some people who suffer from migraines may partake in activities to reduce the risk of having a future migraine such as yoga.

Yoga is thought to work on promoting vagal modification by decreasing the effects of the angiotensin II and nitric oxide pathway. Angiotensin II pathway can block vagal activity in the cardiac muscle, so by incorporating exercise into a patient’s treatment regimen, it is believed to suppress angiotensin II. Nitric oxide can indirectly block effects from the sympathetic nervous system. Another possible mechanism is that integrating slow, mindful exercises may reboot the autonomic nervous system by blocking specific signals and hyperpolarization. This happens because as a person breathes in, they are slowing down receptors and hyperpolarization which eventually leads to the body going into a parasympathetic state.

Yoga has become a popular alternative compared to other therapies for people with other disorders such as anxiety, depression, epilepsy, and back pain. Although the popularity of yoga has risen, there is still a lack of evidence to confirm its effectiveness in migraines. A study was conducted to assess the efficacy of yoga with conventional medicines or the use of conventional medicines alone. Most patients found that conventional treatment with add-on yoga therapy found it to be more beneficial than harmful with no adverse effects. There was also less stress-induced migraines and improved vagal tone on the body caused by the sympathetic nervous system. This may lead to potential progress in health and interventions on cardiovascular diseases. Another recent study was performed to investigate the effectiveness of yoga for the treatment of patients with migraines. The study concluded that patients who participated in yoga therapy experienced an improvement in their quality of life and decreased the frequency of their migraines. Therefore, yoga may be used as add-on therapy with conventional medications for treatment. It was also shown that patients who exercised more had less stress build-up and increased sleep duration at night. Thus, it is important to understand each individual patient because exercise may be a trigger for some patients as noted in the study. However, slow-moving, mindful exercises are beneficial for patients who have high levels of stress and migraines.

References

Mehta, J. N., Parikh, S., Desai, S. D., Solanki, R. C., & G Pathak, A. (2021). Study of Additive Effect of Yoga and Physical Therapies to Standard Pharmacologic Treatment in Migraine. Journal of neurosciences in rural practice, 12(1), 60–66. https://doi.org/10.1055/s-0040-1718842

Kaushik, M., Jain, A., Agarwal, P., Joshi, S. D., & Parvez, S. (2020). Role of Yoga and Meditation as Complimentary Therapeutic Regime for Stress-Related Neuropsychiatric Disorders: Utilization of Brain Waves Activity as Novel Tool. Journal of evidence-based integrative medicine, 25, 2515690X20949451. https://doi.org/10.1177/2515690X20949451

Kisan, R., Sujan, M., Adoor, M., Rao, R., Nalini, A., Kutty, B. M., Chindanda Murthy, B., Raju, T., & Sathyaprabha, T. (2014). Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions. International journal of yoga, 7(2), 126–132. https://doi.org/10.4103/0973-6131.133891

Yoga has been studied more intensely within the past decade as it has been proven as a therapy to many illnesses. Yoga has been used in practice for thousands of years as a gesture to bring unity and harmony to the mind a body. It has been shown that a byproduct of using yoga to bring unity to the body, it was discovered that it can be used for therapy and exercise.

Migraines are headaches that are recurring and can cause moderate to severe throbbing or pulsing pain. It is a neurological condition that can be triggered by many factors and can be different for every patient. These triggers can include hormonal changes, noise, smells, or even changes in the weather or environment. About 12% of Americans suffer from migraines. There is no cure to this condition but there is a variety of treatments that are available to patients to help decrease the frequency and intensity of a person’s migraines. Due to the harsh impact of migraines on some patients, both pharmacological and nonpharmacological treatments are encouraged.

Yoga can be used in conjunction with medication to hopefully decrease medication costs and improve the quality of life of the patient. In a study of 60 patients, half were treated with conventional care while the other half was treated with conventional care and yoga for the treatment of their migraines. The group that received both conventional care and yoga, practiced yoga 5 days a week for 6 consecutive weeks. All patients were asked to keep a migraine journal for the full duration of the study to track their migraines. All patients in the yoga with conventional care group stated the conjunction therapy was more helpful than harmful to their migraines and their quality of life. While aerobic exercise is recommended for patients with migraines, it can also be a trigger for some patients. Since yoga involves slower movements and static muscular exercises, it can be a better alternative to patients because of the lower impact. Since yoga can help develop a mind and body connection and increase awareness of the whole body, it can be more beneficial to patients than aerobic exercise alone. In conclusion, it is shown that yoga can be used as an adjuvant therapy to conventional therapy options to improve patients' quality of life as they live with chronic migraines.

A meta-analysis was conducted with a total of 5 randomized controlled trials and a total of 240 patients were looked at during this meta-analysis. After looking at all of the data, there was evidence that overall, yoga can reduce headache frequency, duration, and pain intensity. However, the evaluation for the different types of headache types showed inconclusive results. With migraines, in particular, there were no statistically significant effects were drawn from the studies overall. More studies should be done to look at the overall long term effects of using yoga for treatment as none of the studies looked at patients’ long term effects.

References:

Anheyer D, Klose P, Lauche R, Saha FJ, Cramer H. Yoga for Treating Headaches: a Systematic Review and Meta-analysis. J Gen Intern Med. 2020;35(3):846-854. doi:10.1007/s11606-019-05413-9

Basavaraddi IV. MEA: Statements : In Focus Articles. Ministry of External Affairs, Government of India. https://mea.gov.in/in-focus-article.htm?25096/Yoga Its Origin History and Development. Published April 23, 2015. Accessed January 19, 2021.

Kisan R, Sujan M, Adoor M, et al. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions. Int J Yoga. 2014;7(2):126-132. doi:10.4103/0973-6131.133891

Migraine. MedlinePlus. https://medlineplus.gov/migraine.html#summary. Published October 8, 2020. Accessed January 19, 2021.

A migraine is an episodic disabling headache that requires long-term treatment and prophylaxis treatment. It is not like a regular headache because it is characterized by accompanied nausea, vomiting, light sensitivity (photophobia) and may have a presence of an aura prior to onset of condition, referred to as the prodromal phase. Nausea and vomiting are associated with the autonomic nervous system (ANS) so that is the reason why they occur since in migraines there is clear autonomic imbalance. It is a very common headache disorder that can be with or without transient neurological symptoms. Migraines tend to affect patients’ overall mood, quality of life and work efficiency. When left untreated, migraines can lead to medication abuse and increased risk of suicidal attempt. Migraine treatment involves both acute, prophylactic and non-pharmacological options. The non-pharmacological approach includes relaxation techniques that are seen as alternative treatment and beneficial for all headache types. One of the non-pharmacological options is yoga. Yoga is characterized by slower movements compared to that of actual exercise that can be a trigger for some patients with migraines. In yoga, the slow movements and static muscular exercises are done while the person is thinking of what they are doing during the act. Yoga also requires feeling of movement and development of body and body motion awareness. Since yoga is non-exertional aerobic exercise, it is much less likely to trigger migraines compared to that of exertional aerobic exercise. Studies have also shown that slower exercise is known to enhance mood and can alleviate depression and stress symptoms. This is done in yoga because it has shown to reduce stress hormones like cortisol, while promoting a stable autonomic nervous system balance which can contribute to the control of the autonomic symptoms associated with the migraine like nausea and vomiting. Studies displayed improvement that was clinically significant in the treatment of migraines with yoga as an adjuvant therapy. This was done to a group of patients that regularly experienced headaches. The group would do yoga for an hour five days a week for six weeks. The patients were asked to keep a headache diary in order to monitor their headaches and symptoms daily. The yoga the patients did consisted of daily loosening exercises, breathing exercises and various postural positions. It showed additional beneficiary effect on patients by reducing the frequency and intensity of their migraine experience. Yoga is also thought to increase vagal tone that benefits autonomic control and helps better control the migraine associated symptoms. Although this benefit is significant, the practice of yoga is only a good add on therapy and may not be beneficial on its own as a primary treatment. Also, the study conducted did not have a placebo group because to do a “sham” yoga is practically impossible. The study only had thirty patients so a larger sample size would be needed to further back up the claims. Delving into alternative therapy that is non-pharmacologic is important because lifestyle modification with the combination of medication therapy is essential to see optimal results.

Reference:

Kisan R, Sujan M, Adoor M, et al. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions. Int J Yoga. 2014;7(2):126-132. doi:10.4103/0973-6131.133891

Migraines are neurological disorders and are thought to occur due to increased excitability in some areas of the brain. It is often characterized as a debilitating headache that occurs in episodes and requires long-term treatment management. An autonomic nervous system imbalance explains many of the clinical symptoms of the migraine disorder such as nausea, vomiting, flushing, and diarrhea. In some cases, migraines can be so severe that they reduce productivity in everyday life as well as reduce the quality of life for each patient. About 13% of the population worldwide experience migraines that are known to impact productivity at work and cause cognitive impairment. When this condition is not treated properly, it may lead to medication overuse headache and increased risk of suicidal attempt. When patients have exhausted all medication options for treating migraines, they often wonder if anything out there would be able to treat the condition. Patients can try alternatives to help treat their migraines, one of them being yoga therapy. Migraine management through yoga therapy would reduce the medication costs for the patient and is shown to improve overall quality of life. Yoga therapy can also be used as adjunctive therapy if medication alone is not reducing migraine episodes enough.

In a 2014 study, sixty migraine patients between 15-69 years old were randomly given either traditional medication treatment care or yoga added to their medication therapy regimen. The patients had to be diagnosed with migraine disorder with or without aura, had to have a history of migraine disorder for at least two years, and a headache frequency of 5 to 15 months. Patients were advised to maintain a migraine diary in the total 6-week study period. The yoga group received yoga practice for five days a week for the total study period in addition to their usual medication regimen. The yoga intervention consisted of a daily practice of loosening exercises, breathing exercises, as well as postures trained by certified yoga therapists. Furthermore, the study collected a record of attendance and compliance to the yoga intervention every day. At the end of the six-week post intervention, assessment was done on each patient and the migraine diary was collected.

The study group that practiced yoga in addition to their regular treatment, 29 out of 30 patients (vs. 9 in the control group) had an overall improvement in headache frequency, intensity, and duration compared to the conventional care group alone. The average migraines per month went down from 11.3 episodes to 1.8 episodes in the yoga group, and 10.5 episodes to 5.2 in the control group. In addition, the yoga group experienced an enhancement in vagal tone, decreased sympathetic drive, and improvement in cardiac autonomic balance. The yoga intervention group also had a significant reduction in heart rate compared to the conventional group at the end of the six weeks, making it beneficial in migraine treatment. Yoga in any disease state has shown to reduce stress patterns, cortisol levels, and bring stable autonomic balance and health. It has been effective in many other disease states such as asthma, diabetes, arthritis, depression, and fibromyalgia where stress is shown to be a constant trigger in flare ups.

Kisan, Ravikiran et al. “Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions.” International journal of yoga vol. 7,2 (2014): 126-32. doi:10.4103/0973-6131.133891

Yoga as a migraine treatment

A total of 114 patients completed the trial and were evaluated to the effectiveness of yoga as a medical management therapy for patients with migraines. This randomized open label trial took place in a tertiary care academic hospital in India. Patients between the age of 18-50 years old with episodic migraines were randomized to either those only on medication and those on medication who also practice yoga. Episodic migraines were defined as patients that experience 4-14 headaches per month. The yoga group would do 1 hour yoga practices 3 days a week for a total of 1 month. The patients were asked to note down information about their migraines, including the duration, severity and the medication taken. The results showed that everyone saw improvement, but there was an additional benefit seen with those who also did yoga. The headache occurrences starting with an average of 9.1 headaches per month and ended in a 3 month study period of 4.7 headaches per month, which is a 48 percent reduction. The medication only group saw only a 12 percent decrease. After 3 months, the average number of pills that were taken also decreased by 47 percent while the average amount of pills taken in the medication only group decreased by about 12 percent. Another study also supports this evidence as well, to show that yoga can be effective in alleviating migraine symptoms. Yoga is known to enhance the vagal tone and decrease sympathetic drive, which would improve cardiac autonomic balance.

https://www.healthline.com/health-news/yoga-can-help-relieve-migraine-symptoms

https://n.neurology.org/content/early/2020/05/06/WNL.0000000000009473

https://www.ncbi.nlm.nih.gov/pubmed/25035622