The AAO Journal, 2025/06, 35(2):21. doi: 10.53702/i2375-5717-35.2.13, type of study: ,cr,

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p13.xml)

Keywords:

case report [736]
female [655]
migraine [69]
OMT [3925]
osteopathic manipulative treatment [3946]
women [608]

Abstract:

Introduction: Chronic migraines are a major cause of disability, contributing to frequent emergency department visits and substantial socioeconomic burden. Standard management involves a “migraine cocktail“ comprising intravenous fluids, NSAIDs, triptans, and anti-emetics. This case highlights the potential efficacy of osteopathic manipulative treatment (OMT) as a conservative, adjunctive approach to chronic migraine management, enhancing patient outcomes and quality of life. Case Description: A 34-year-old female presented to urgent care with an acute exacerbation of chronic left-sided migraine with aura, vomiting, and diarrhea, seeking her routine injection-based therapy. Osteopathic evaluation revealed significant cranial and viscerosomatic strain patterns involving the eyes. Results: The patient underwent a brief OMT session, including Osteopathy in the Cranial Field (OCF), ligamentous articular strain (LAS), and balanced membranous and ligamentous tension (BMT/BLT) in a seated position. Her symptoms resolved entirely without pharmacologic intervention. She was referred to an Osteopathic Neuromusculoskeletal Medicine (ONMM) clinic for continued care. Further evaluation identified a history of concussions, motor vehicle collisions, root canals, and a presumed right short leg. Serial OMT sessions achieved increasing migraine-free intervals (3–5 months). Imaging revealed a 15mm left short leg, complicated by compensatory patterns from a prior right proximal lateral tibia fracture. Targeted OMT, scar infiltration, and perineural injections addressed intraosseous and myofascial dysfunctions, resolving a right-sided clinical leg length discrepancy. Two months later, the patient developed a cervicogenic migraine and a left clinical leg length discrepancy. OMT normalized leg lengths, sustaining migraine resolution. Discussion: This case demonstrates OMT’s effectiveness in chronic migraine management, reducing pharmacologic reliance and emergency care. OMT represents a cost-effective, conservative intervention that significantly enhances patient outcomes and quality of life.