A RANDOMIZED CONTROLLED TRIAL ON THE EFFECTIVENESS OF COURT-TYPE TRADITIONAL THAI MASSAGE VERSUS AMITRIPTYLINE IN PATIENTS WITH CHRONIC TENSION-TYPE HEADACHE

Abstract

This study aims to evaluate the effectiveness of the court-type traditional Thai massage (CTTM) in treating patients suffering from chronic tension-type headaches (CTTHs) in comparison with amitriptyline. A randomized controlled trial was conducted at the Department of Traditional Thai Medicine, Bamnet Narong Hospital, Amphur Bamnet Narong, Chaiyaphum Province. Sixty patients aged 18-65 years who were diagnosed with CTTH according to the criteria of the International Headache Society (IHS) participated. Using random allocation, 30 patients were assigned in treatment group and received a 45-minute course of court-type traditional Thai massage twice per week for 4 weeks. The other 30 patients were assaigned into the control group. They were advised to take 25 mg once daily before bedtime for 4 weeks. On the first day of the therapy, the participants in the treatment group were evaluated right after the massage therapy. Those in the control group, in contrast, were evaluated on the next day because they would take Amitriptylene that night. Evaluation was also conducted again in week 2, week 4, and with a follow-up in week 6. These included the VAS, the 24-HVAS, the self-stress assessment (only before the commencement of the therapy), the cervical range of motion (CROM), and tissue hardness, pressure pain threshold, and heart rate variability (HRV). An analysis of variance with repeated measure (repeated ANOVA) was used for within-group comparison, and analysis of covariance (ANCOVA) for between- group comparison. In terms of both CVAS and 24-HVAS, the results showed a statistically significant decrease in pain intensity for the CTTM group at different assessment time points. A statistically significant difference was found for between-group comparison at each assessment time point (P<0.05) for each of the evaluation parameters. Specifically, the patients in the CTTM group reported a lower headache frequency and duration. Additionally, the PPT of the CTTM group increased significantly (P<0.05). As for tissue hardness, the value for the CTTM group was significantly lower than that of the control group at week 4. Finally, the HRV of the CTTM group was increased significantly (P<0.05) in terms of SDNN, RMS-SD, and LF. It can therefore be concluded from the findings that CTTM seems to be an effective therapy for enhancing the function of the parasympathetic nervous system and other stress-related variable as well as reducing CTTHs. It is suggested that CTTM should be an alternative therapy for CTTH.