Ayurveda for management of migraine: A narrative review of clinical evidence

Abstract

Migraine is a primary headache disorder characterized by recurrent attacks. The economic and societal burden of migraine is substantial, affecting patients’ quality of life in terms of work, social activities, and family life. This article attempts to review the available literature for clinical evidence of Ayurveda in the management of migraines. We performed a literature search from January 2000 to July 2020 on popular search engines such as Pub Med, Google Scholar, and AYUSH Research Portal using the keywords “Complementary and Alternative Medicine (CAM) and Migraine”, “Ayurveda and Migraine” and “Panchakarma and Migraine”. The selection criteria involved published clinical trials, including pilot studies, whereas review articles, concept papers, letters to the editor, and studies published in languages other than English were excluded. Out of 77 studies that were screened, 12 articles that satisfied the selection criteria consisted of six Randomized controlled Trials (RCTs), five non-RCTs, and one pilot study. Among them, ten studies used polyherbal and Herbo mineral formulations, two studies contained no oral medications, three trials utilized external therapies, and ten studies used panchakarma procedures. Eleven studies found Ayurveda to be clinically beneficial as monotherapy, while one study demonstrated the usefulness of Ayurveda as an add-on to conventional management. This review reveals the beneficial role of Ayurveda in the management of migraines without many side effects. Yet several limitations exist, like small sample size, short follow up, and lack of better outcome measures for pre and post-assessments. Future research should overcome these limitations and follow a robust methodology so that definitive conclusions can be drawn.

An Asian perspective on complementary and alternative medicine in the treatment of primary headache disorders

“…A review of 12 studies which utilized Ayurvedic polyherbal formulations or herbmineral formulations found phytotherapy to be clinically beneficial in the management of migraine. 19 However, this review was limited by small sample size, short follow up, and nonspecific outcome measures. A study on Kampo (Japanese herbal) medicine for primary headaches as an acute treatment showed no significant difference in response between Kampo and non-steroidal anti-inflammatory drugs (NSAIDs).…”

“…Treatment modalities include Shodhana (purification) procedures Nasya (nasal instillations) and Virechana (therapeutic purgation), as well as Shamana (pacifying) therapies in the forms of Kasaya (herbal liquid), Kalka (pastes) and Guli (tablets). 19 Another technique used in Sri Lanka is the application of a Hisa kudichchi, a medicinal pack made of herbal leaves on to the patient's head for SLJoN ⏐ WIJESUNDARA approximately 15 minutes. It is said that this treatment allows the patient to feel cool and free of a heavy head.…”