Efficacy of electromyographical (EMG) and thermal biofeedback in management of migraine

Abstract Background There are many effective treatments for migraine, ranging from medication to self-help and behavioral therapy. However, the treatment with medication only is not effective in many cases and has many side effects. There is a need for other therapies combined with medication. This work aimed to evaluate the efficacy of EMG and thermal biofeedback in management of migraine in comparison with drugs. The study was conducted on 45 patient with migraine diagnosed according to The International Classification of Headache Disorders 3rd edition. The patients were divided into three matched groups: Group (A): 15 patients treated with drugs (propranolol) only. Group (B): 15 patients treated with EMG and thermal biofeedback therapy only. Group (C): 15 patients treated with both drugs and biofeedback therapy. The patients were assessed before and after therapy by Migraine Disability Assessment Scale (MIDAS). Results Migraine Disability Assessment Scale (MIDAS) after 2.5 months of treatment was comparable between Group I and group II and significantly higher in group I and group II than group III. EMG score was similar between group II and group III at 1st session, 2nd session, 3rd session, 5th session, 7th session, 8th session, 9th session and 10th session and higher significantly in group II than group III at 4th session and 6th session. EMG score increased in both groups within time. Temperature score was comparable between both group II and III at all sessions. Conclusions EMG and thermal biofeedback is effective treatment of migraine disorder. with non-significant difference in improvement from propranolol . EMG and thermal biofeedback combined with propranolol are more effective than either of them alone in management of migraine.