Manual Lymph Drainage in Individuals With Migraine
Condition: Manual Lymphatic Drainage
MeSH terms: Migraine Disorders
Study type: Interventional

Summary: 
      In the literature, research into the examination of the effect of MLD on migraine is quite
      limited. Our study aimed to examine the effectiveness of manual lymph drainage and connective
      tissue massage treatments on neck pain and disability, sleep quality, pain threshold and
      severity, depression and quality of life.
    

Detailed description: 
      Although there are evidence-based guidelines for clinical decision-making and reporting the
      care of patients with migraine, migraine management for the population is inadequate. Even
      among individuals who are correctly diagnosed, almost more than half of patients are not
      administered any acute or preventive treatment. Various invasive and non-invasive treatment
      options are available in the treatment of migraine. Relaxation training, exercise, cold
      application, massage, transcutaneous electrical nerve stimulation (TENS), biofeedback,
      manipulation and mobilization techniques, and trigger point therapy are some of the
      non-invasive treatment options used in migraine treatment. These treatments, which can be
      applied independently, can also be applied in combination with pharmacological treatments in
      some patients. In addition, the patient's knowledge about the disease makes it easier to
      manage the process and cope with the pain better.

      Connective tissue massage (CTM) is a manipulative therapy method that is different from
      traditional massages in terms of both technical and physiological effects and has been used
      for diagnosis or treatment since 1928. Although the manipulative procedures applied target
      superficial connective and subcutaneous tissues, they also have effects on organs far from
      the local stimulation area. Another approach to migraine prophylaxis includes manual lymph
      drainage (MLD). It is considered that MLD causes sympathetic and parasympathetic effects and
      is similar to therapeutically effective relaxation therapy by reducing the hyperexcitability
      of the central system. With the parasympathetic effect it creates, it helps to reduce muscle
      pain and spasm, making it easier to cope with tension and stress. Reduction of the tension
      and stress factors may reduce the triggering of migraine and make it easier to cope with the
      current migraine. Recent studies have shown that the meningeal lymphatic system is located in
      the brain and that this system is a new way for the drainage of the cerebrospinal fluid.

      In the literature, research into the examination of the effect of MLD on migraine is quite
      limited. We planned this randomized controlled trial to contribute to the reduction of pain
      and increase the quality of life of individuals with migraine by increasing the awareness of
      individuals working in this field in our country.
    

Intervention name(s): Connective Tissue Massage; Manual Lymph Drainage
Intervention type(s): Other; Other
Intervention description(s): In participants in the CTM group, the treatment was started with the sacral region called the "basic region" and the whole back was treated. Pulls in the interscapular region were more intense than in other regions. After the interscapular region, the cervical, clavicular, and facial regions were also included in the treatment. Both short and long pulls were used according to the region during CTM. The applications first started with the basic region and then progressed to the lower thoracic, scapular, and interscapular regions. Then, the cervical and clavicular regions were treated. In each region, the applications were performed three times on each of the right and left sides. While positioning the patients, we paid attention to their privacy and the temperature of the room where the treatment was carried out. A total of 12 sessions, which were conducted 2 days a week and took 6 weeks, were performed.; The patients, who had filled out their pain diary before and submitted a consent form, were first evaluated before the treatment and then they lay on their back with their neck area open, paying attention to the protection of their privacy. Hand strokes, one of the basic techniques applied for treatment, were planned in accordance with the anatomy and physiology of the lymphatic system. MLD was applied to the lateral neck and face region in 5-7 repetitions so that the lymph collectors could give an adequate reaction to the application. The treatment was performed 2 days a week for 6 weeks, with a total of 12 sessions. Each session lasted 45 minutes.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study included forty individuals with migraine. Participants' neck pain was evaluated with the Neck Pain and Disability Scale, pressure perceptions and pain sensitivity with an algometer, quality of life with the Short Form-3, and headaches with a pain diary kept for 15 days before and after treatment. Then, the individuals were randomly divided into two as the manual lymph drainage group and the connective tissue massage group. Both groups were treated for 45 minutes twice a week for 6 weeks. The groups were assessed before the treatment and at the end of 6 weeks.
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Migraine; Manual Lymphatic Drainage; Connective Tissue Massage; Quality of Life