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DEEP DIVE

“Progressive muscle relaxation”: the game changer

 

 

The fact that stress is a key factor in the development of migraine attacks is undisputed and repeatedly backed up by research. In practice, it is clear that people with migraine who succeed in reducing their personal stress levels can see a considerable improvement in their symptoms. However, it is often difficult to reduce stress in everyday life. Numerous studies show that regular, targeted relaxation exercises can have a significant effect here. In terms of evidence-based medicine, so-called “progressive muscle relaxation” is considered a particularly good method.

 

“Progressive muscle relaxation”: what exactly is it?

In the 1920s and 1930s, the American doctor and psychologist Edmund Jacobson (1888-1983) developed a relaxation method with which patients were meant to improve their instinct for muscular tensions in the body and learn targeted relaxation. The aim of the technique is to improve overall bodily awareness and to purposefully guide the entire body into a state of deep relaxation through the conscious tensing and relaxation of different muscle groups. People who use this technique can then also benefit from further, related effects – such as a marked reduction in feelings of stress.

Originally, the method was designed for 16 different muscle groups. Scientists later developed it further and shortened it in order to simplify its implementation. For example, a ten-minute version, which can be easily integrated into your daily routine, can be found in the Headache Hurts app or here on the homepage. The method has already been used to prevent migraine since the 1970s and was later also used to prevent tension-type headache. In medical practice, it has become apparent that its easy learnability and flexibility in implementation (in terms of time as well as space) are particularly advantageous for patients.

 

The figures support the method

An early meta-analysis on the effectiveness of progressive muscle relaxation in headache prevention was already produced in 1980. It examined the effectiveness of various methods – e.g. biofeedback and autogenetic training as well as progressive muscle relaxation – in comparison to relevant control groups. Among the total of six studies on progressive muscle relaxation which were examined, we can see that, at 53%, there was a considerable improvement compared to the control group. This method is therefore the most effective out of the preventative measures for migraine.

The effectiveness of progressive muscle relaxation for preventing migraine could also be repeatedly proven in the last few years. In a German study from 2016, people with migraine practised regular progressive muscle relaxation exercises over a period of six weeks; there was also a control group here. Initially, they incorporated 16 muscle groups, in line with Jacobson’s idea. This was subsequently reduced to seven and finally to four muscle groups in the following two sessions. The number of migraine attacks which the affected people had per month, as well as the total number of days on which they experienced migraine, were measured. After the program had been completed, the number of attacks was reduced by 41% and the number of migraine days by 43%. The effect was stable and continued during a follow-up period.

 

What makes progressive muscle relaxation so effective?

A study from 2017 considers the physiological causes for the demonstrably high effectiveness of progressive muscle relaxation with regard to migraine. The authors come to assume that the activation level of the pain processing system, which is raised for people with a predisposition to migraine, can be lowered by using this technique, thereby reducing the imminent risk of attacks. The authors also reported a simultaneous activation of pain-inhibiting structures in particular areas of the brain. As a result, the frequency and severity of the pain, the intensity of the attacks, and medication use are significantly reduced after carrying out the exercises. Furthermore, according to the study, an improvement in terms of mental stress, which develops in affected people through the migraine, can also be observed. Here, the authors again emphasise that progressive muscle relaxation is better than other, non-medicinal methods, on the one hand due to its high effectiveness, but also due to its easy learnability and universal usability at any time and in any place.

 

A decisive factor: people with migraine are regaining their autonomy

The aforementioned German study from 2016 also makes one further observation, one which might offer encouragement to many people with migraine. Over the period during which the patients were regularly making use of the relaxation technique, they became increasingly confident in their own ability to handle ‘their’ migraine. With every stage of the exercise, they became more and more certain that they could manage this illness themselves and felt increasingly less helpless when faced with it. This feeling of capability often results in a significant improvement in quality of life for the affected people and can motivate them to begin taking on further preventative measures for migraine. In this way, progressive muscle relaxation can not only lead to a marked improvement in symptoms, but in many cases, it also paves the way for the affected people to have a sustainable, actively preventative approach to their own illness.

 

 

 

  • Bernstein, E.A., & Borkovec, T.D.: Progressive relaxation training: A manual for the helping professions, Champaign, IL: Research Press, 1973

    Blanchard EB, Andrasik F, Neff DF, Arena JG, Ahles TA, Jurish SE, Pallmeyer TP, Saunders NL, Teders SJ, Barron KD, Rodichok LD. Biofeedback and relaxation training with three kinds of headache: treatment effects and their prediction. J Consult Clin Psychol. 1982 Aug;50(4):562-75. doi: 10.1037//0022-006x.50.4.562. PMID: 6749918.

    Hyman RB, Feldman HR, Harris RB, Levin RF, Malloy GB. The effects of relaxation training on clinical symptoms: a meta-analysis. Nurs Res. 1989 Jul-Aug;38(4):216-20. PMID: 2664718.

    Jacobson, Edmund: Progressive Relaxation, The American Journal of Psychology, Vol. 36, No. 1 (Jan. 1925), pp. 73-87, University of Illinois Press

    Kropp P, Meyer B, Dresler T, Fritsche G, Gaul C, Niederberger U, Förderreuther S, Malzacher V, Jürgens TP, Marziniak M, Straube A. Entspannungsverfahren und verhaltenstherapeutische Interventionen zur Behandlung der Migräne : Leitlinie der Deutschen Migräne- und Kopfschmerzgesellschaft [Relaxation techniques and behavioural therapy for the treatment of migraine : Guidelines from the German Migraine and Headache Society]. Schmerz. 2017 Oct;31(5):433-447. German. doi: 10.1007/s00482-017-0214-1. PMID: 28364171.

    Meyer B, Keller A, Wöhlbier HG, Overath CH, Müller B, Kropp P. Progressive muscle relaxation reduces migraine frequency and normalizes amplitudes of contingent negative variation (CNV). J Headache Pain. 2016;17:37. doi: 10.1186/s10194-016-0630-0. Epub 2016 Apr 18. PMID: 27090417; PMCID: PMC4835398.

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