This document summarizes a study examining the prevalence of cervical mobilization and acupuncture therapy adopted by physical therapists for treating migraines. The study involved distributing questionnaires to 150 physical therapists in Faisalabad, Pakistan to determine which treatment methods they most commonly use. The questionnaires addressed types of cervical mobilization and grades used to treat migraine patients in both private and public clinics. The purpose was to identify the most effective interventions for relieving migraine symptoms and reducing pain.

1. Prevalence of preference among cervical
mobilization and acupuncture therapy
adopted by PT for the treatment of
migraine

2. INTRODUCTION
• Migraine is a neurological disease with recurrent moderate to severe
headaches often in association with different symptoms. Many
people use the term "migraine" to describe any headache, a migraine
is the result of specific physiological changes that happen within the
CNS and lead to the pain and relative symptoms of a migraine. A
migraine headache can cause concentrated throbbing or a pulsing
sensation in one area of the head.

3. PATHWAYS OF MIGRAINE
• The absolute cause of migraine is still unknown. Recently some evidence
suggests that the following said sequence of pathways (Figure) happened.
Migraines are characterized by recurrent, pulsating pain on one or both
sides of the head and are generally accompanied by one or more
symptoms. First: Migraine originate deep within the brain. Second:
Electrical impulses spreading to other parts of the brain. Third: Changes in
nerve cell performance and blood flow results in symptoms such as
visual disturbance, numbness and tingling sensations and may dizziness.
Forth: Chemicals in the brain affects blood vessel and it will cause dilation
and inflammation or swelling of surrounding tissue. Fifth: The
inflammation moves toward nerve supplied by the trigeminal nerve
causing pain.

5. SIGNS OF MIGRINE
• 1.excitment, depression, irritability
• 2. Lack of sleep Waking up overtired
• 3. During migraines, most people will have an
• 4. Dusty nose or water in eyes
• 5. Cravings: Before a migraine attack occurs, some people crave for foods. “Like chocolate,"
• 6. Character of pain is Pulsing and throbbing on one or may on both sides of the head
• 7. Eye pain: Migraine pain often behind the eye burrows.
• 8. Neck pain: Stiffness of neck very common at the early stages of the migraine
• 9. Urgency: If you urinate many time very rottenly it may be that a sign migraine is coming
• 10.Yawning: Yawning all time is another sign that a
• 11. Numbness and tingling
• 12. Vomiting.
• 13. Sharp Light, loud noise, or different smells trigger or worsen the migraine pain.
• 14. Trouble with the speaking: Speech problems can be another symptoms that a migraine will
attack
• 15. Increasing pain during physical activity.

6. THINGS TRIGGERS MIGRAINE
• 1. Anxiety.
• 2. Stresses.
• 3. Lack of food or sleep.
• 4. Exposure to light.
• 5. Change of in women.

7. CAUSES
• 1. depression.
• 2. Oral contraceptive pills.
• 3. Pregnancy.
• 4. Hunger.
• 5. Fatigue.
• 6. Perimenopause.
• 7. Stress.
• 8. Anxiety

8. REVIEW OF LITERATURE
• The aim of this study to highlight the migraine problem and to find the
prevalence of cervical mobilization and acupuncture therapy for migraine
treatment all over the Faisalabad. A cross sectional review of 150
Physiotherapists (M = 90, F = 60).
• The study consist on a questionnaire, which includes different question,
based on YES/NO and somehow on reason to specify the aim of therapy
adopted by PT for migraine.
• The questionnaire includes the different types/method of cervical
mobilization and grades according to which a PT treat the migraine
patients.
• The purpose of study is to know which therapy is mostly use for migraine
by PT in private and government sectors. The population in this study are
trained, well experienced and skilled PT’S.

9. Rationale
The lifestyle that need exposure to the society is having large rate migraine pain
due to sharp lights and loud noises and bad smells that triggers it. Utilization of
high energy power in a repetitive manner to constant headache and stiffness of
neck after which demand on neck muscle, the new and better interventions can be
developed for migraine. It leads towards a cure for migraine being found. After a
complete diagnosis we were lead towards the treatment. There is many different
mechanical techniques to cure migraine. We study on that which treatment has
longer effects and are more effective. Different trigger points that leading towards
migraine attack. This type of pain needs proper treatment because the pain cannot
relieve by home remedies. The simple types of mechanical techniques like cervical
mobilization and acupuncture therapy shows the relieving effects. Therefore, the
main purpose of this study is to determine which intervention has more effects that
are adopted by therapists in their clinics.

10. MATERIAL AND METHODS
• Study Design:
• Cross Sectional study
• Study Setting:
• Madinah Teaching Hospital
• Allied Hospital
• DHQ Faisalabad
• MD Hospital
• Maqsooda Zia Hospital
• Aziz Fatima Hospital
• Chinoit Hospital
• Study Duration:
• After approval 6 weeks.
• Study Population:
• Both male and female of age 30 to 50.
• Sample Size:
• Sample size will be 150 to 200.
• Sampling Technique:
• Purposive sampling technique will be used for sampling.
• Screening of study population: Screening will be done on the basis of inclusion and exclusion criteria

11. Inclusion Criteria:
• PT who are willing
• PT of both male and female
• PT who are well experienced and skilled in his/her field
• Outpatient department within hospital
• Clinics which is open more than 4 days a week
• In-home clinics which are affiliated with specific companies
• Private medical clinics provide primary care services

12. Exclusion criteria
• PT who are freshly graduated
• Health clinic without permanent medical doctor
• Rural Health Clinics
• Clinic which provide only child health services
• Clinic which operates less than 4 days a week

13. • Data Collection Tools:
• Questionnaire Forms
• Data analysis:
• SPSS version 20
• Data collection procedure:
• Participants will be educated about the study topic and its method.
• Participants will be asked if they are willing to participate in the study.
• Participants who will be willing to participate will be given a consent form.
• Then screening will be done on basis of inclusion and exclusion criteria.
• Data will be collected through questionnaire.
• Questions will be translated to Urdu for those participants who will be
unable to understand English.