Nonpharmacological management of headaches during pregnancy

Concerns about the effects of maternal medications on the growing baby limit the use of medication treatment for benign conditions, such as recurring headaches, during pregnancy and lactation. Nonpharmacological therapies hold particular promise for pregnant women due to the limited medication options. No controlled studies, however, have reported on the efficacy of nonpharmacological treatments for pregnant women. The first study evaluated the effectiveness of a combined nonpharmacological treatment (CT) consisting of relaxation, skin-warming biofeedback, and physical therapy for pregnant women with chronic headaches. In a second study, the CT protocol was compared with an attention control (AC) that received headache education and skin-cooling biofeedback. The first study resulted in significant symptom improvement in 79% of subjects, with an overall 72.9% reduction in headaches. In the second study, both groups improved with treatment; however the CT group was more likely to experience significant headache relief (72.7%) than the AC group (28.6%, chi 2(1) = 4.97, p < .03). Significant improvement was maintained at a 6-month follow-up for over 50% of patients. It is concluded that the combined nonpharmacological treatment was more effective than an attention control in reducing headaches during pregnancy. This treatment was effective regardless of predisposing variables.