In an open, randomized trial, we evaluated transcutaneous electrical nerve stimulation (TENS), infrared laser therapy and acupuncture in the treatment of transformed migraine, over a 4-month period free of prophylactic drugs. Sixty women suffering from transformed migraine were assigned, after a one month run-in period, to three different treatments: TENS (Group T; n=20), infrared laser therapy (Group L; n =20) or acupuncture (Group A; n=20). In each group the patients underwent ten sessions of treatment and monthly control visits. In Group T patients were treated for two weeks (5 days/week) simultaneously with three TENS units with different stimulation parameters (I: pulse rate = 80 Hz, pulse width = 120 micros; II: 120 Hz, 90 micros; III: 4 Hz, 200 micros). In Group L an infrared diode laser (27 mW, 904 nm) was applied every other day on tender scalp spots. In Group A acupuncture was carried out twice a week in the first two weeks and weekly in the next 6 weeks. A basic formula (LR3, SP6, LI4, GB20, GV20 and Ex-HN5) was always employed; additional points were selected according to each patient's symptomatology. The number of days with headache per month significantly decreased during treatment in all groups. The response in the groups differed over time, probably due to the different timing of applications of the three methods. TENS, laser therapy and acupuncture proved to be effective in reducing the frequency of headache attacks. Acupuncture showed the best effectiveness over time.
A maxillary alveolar mucosal inflammation, demonstrated by local tenderness and increased temperature, is present in migraine, tension-type headache and facial pain patients even when the patient is asymptomatic. Research is presented showing effective treatment of these conditions with fewer side effects than with standard medication by local anti-inflammatory methods. These alternative methods include: chilling, application of anti-inflammatory gel and low-level (non-cutting) laser. Local treatment also mediates cervical muscle spasm, adding to its overall effectiveness.