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.