We want to be straight with you on this one, because being honest about the evidence matters more than telling a good story. This trial tested whether manual therapy could work as a preventive treatment for migraine, aiming to reduce the number of migraine days people have.
Researchers compared manual therapy, including posture and neck exercises, against usual care from the GP, and followed people for a full year. It is worth knowing upfront that the study fell short on recruitment and Covid disrupted it, so it ended up smaller than planned, with 67 people instead of the intended 196.
Not every study is a glowing result, and that is exactly why it is worth reading. A clinic that only shares the wins is not being fair with you. Here is what this trial actually found.
Hands-on treatment together with postural and cranio-cervical (neck) exercises, delivered as a preventive program rather than a one-off.
The comparison group carried on with usual care from their doctor, which for some included starting preventive migraine medication.
On the main goal, reducing migraine days, manual therapy was not better than usual care. But the fuller picture has some genuine positives worth knowing.
Manual therapy did not reduce migraine days more than usual care. Both groups improved and ended up similar.
53% in the manual therapy group rated themselves much or very much improved, compared with 29% in usual care.
Manual therapy significantly reduced other, non-migraine headaches at 52 weeks.
Pressure pain thresholds around the back of the head improved, meaning the area was less tender after treatment.
For migraine days specifically, manual therapy was no better than usual care in this trial. But the people who had it felt more recovered, were more satisfied, and had fewer everyday headaches. So it is not a migraine cure, but it may still have a supportive role.
We would never claim to treat or cure migraine. Migraine is a neurological condition, and it belongs with your doctor. What this study suggests is that hands-on care can sit alongside medical management as support, and that people often value it even when it does not change the migraine count itself.
If you get migraines and also carry a lot of neck and shoulder tension, or you get other tension-type headaches on top, that is where our work may help. We would always want you working with your GP or neurologist on the migraine side.
Supports a role in easing neck tension and other headaches, as support alongside medical migraine care, not as a migraine treatment.
Backs manual therapy plus exercise as a well-tolerated, patient-valued option to sit beside GP care.
Reinforces neck and shoulder release for people who value hands-on care, within a wider plan.
May help associated muscle tension, again as support rather than a migraine cure.
This is a small trial that did not reach its recruitment target, and Covid disrupted it, so the results should be read with real caution. Half of the eligible people declined to be randomised because they preferred manual therapy, which can skew things, and the usual-care group used more preventive medication, which may have helped them catch up.
Because of all this, we would not read too much into any single number here. The honest summary is that manual therapy did not beat usual care for migraine days, but was safe, valued, and helped with other headaches.
In this trial, manual therapy did not reduce migraine days more than usual GP care, but people felt more recovered, were more satisfied, and had fewer other headaches. Migraine care belongs with your doctor, and hands-on treatment may play a supportive role alongside it.
Effectiveness of manual therapy as a prophylactic treatment for migraine: a randomized controlled trial. Amons AL, and colleagues. Archives of Physiotherapy, 2026. Please confirm the full citation at the source before publishing.
