Written by Nick Zelt
This meta-analysis supports the recommendation of yoga as a treatment for migraine. How this generalizes to the emergency department is unknown.
Why does this matter?
Migraines are one of the leading causes of disability worldwide and account for a significant proportion of headache complaints presenting to the ED. First line treatment is typically pharmacological, but data for drug-free interventions exist. Some randomized controlled trials (RCT) have shown benefit to yoga for reducing headache frequency, intensity, and duration. A meta-analysis would allow for more certain recommendations.
Tying knots with the body soothes the mind
This was a systematic review and meta-analysis of 6 RCTs in which patients were randomized to either yoga therapy or standard care. The primary outcome was pain intensity, which was significantly lower with yoga therapy, a decrease of 1.21 points on a ten-point scale. The secondary outcomes of headache frequency, duration, HIT-6 score and MIDAS score were also significantly improved by yoga.
These are positive findings, but there were some limitations. The authors used the Jadad score to measure study quality, which is a bit outdated and very simplistic. Additionally, none of the studies included emergency department patients. The authors made no comment on how this might affect generalizability, and I’m left wondering why this was published in an emergency medicine journal. All the same, if your patient isn’t satisfied with their current treatment and hasn’t tried yoga yet, perhaps it would be worth a try.
Effectiveness of yoga therapy for migraine treatment: A meta-analysis of randomized controlled studies. Am J Emerg Med. 2022 May 2;58:95-99. doi: 10.1016/j.ajem.2022.04.050. Epub ahead of print.