BACKGROUND: Migraine is one of the most important causes of disability worldwide and is a frequently accompanied by neck pain. The aim of this study was to evaluate the effect of upper cervical manual therapy (MT) on headache characteristics, central sensitization (CS) and disability in subjects with migraine and neck pain. METHODS: 30 subjects with migraine and neck pain (30 female, mean age 43.10 +/- 8.13) were randomly assigned to MT group (MTG), sham MT group (SMTG), and a control group (CG). Central sensitization inventory (CSI) score, disability indices including neck disability index (NDI) and Headache Impact Test (HIT-6), headache characteristics, and medication use were evaluated in all subjects pre and post intervention. Subjects in the MTG and SMTG received either 4 sessions of MT or sham MT. Subjects in the CG received medication only. RESULTS: Subjects in the MTG had a significant reduction in headache characteristics, medication use, CSI score, and disability indices (p < 0.05). CSI score was positively correlated with headache days, headache duration, and NDI score (p < 0.05). Conclusions. Upper cervical MT have beneficial effects on headache symptoms, disability, and CSI score in subjects with migraine and neck pain. The result of this study suggests that MT may be a useful component in the multimodal management of migraine. STUDY REGISTRATION: The trial design was registered in the Iranian Registry of Clinical Trial (IRCT ID: IRCT20160621028567N2, url: https://www.irct.ir/) before the first patient was enrolled.

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