Individualized physiotherapy management in migraine patients: A case series

Aim Physiotherapy interventions in migraine patients have been previously studied; however, the evidence supporting their use is still limited. In almost all the studies, migraine patients receive a standardized physiotherapy protocol, regardless of their clinical presentation and the findings of the physical assessment. The aim of this case series is to describe three patients treated with an individualized physiotherapy approach, tailored to their symptom presentation, physical assessment findings, patient preferences, migraine phase, and the overall clinical picture. Methods We present three patients with neck pain and migraine without aura who were treated with eight sessions of individualized physiotherapy over a 2-month period. Two of them presented with cervical musculoskeletal disorders (CMDs) without major cervical sensitization. The third one presented with only minor CMDs but had significant cervical sensitization. We describe the clinical reasoning underlying the treatment approach we used for the three patients. Results All three patients showed improvement in both migraine and neck pain frequency and disability that lasted over the follow-up period. The improvements matched their global impression of change ratings. Conclusion An individualized physiotherapy approach is underpinned by clinical reasoning and is a promising component within overall migraine management.