Comparative Insights into Physiotherapy Expectations Among Chronic Migraine Patients with and without OnabotulinumtoxinA Treatment: A Case–Control Study

Physiotherapy and rehabilitation treatments (PRT) complement OnabotulinumtoxinA (OnaBotA) in migraine management to avoid excessive drug use and reduce chronicity-related problems. This case–control study aimed to compare the perspectives and expectations of PRT in chronic migraine (CM) patients who received and did not receive OnaBotA. The research question of this study is: What are the perspectives and expectations of CM patients who receive and do not receive OnaBotA towards PRT? Patients in the application list were divided into two as those who received OnaBotA treatment (n = 55) and those who did not (n = 53). Clinical questions and evaluations of 108 CM patients who applied to the neurology clinic were made by phone or answered via e-mail. The patients' characteristics and opinions regarding PRT were evaluated with our clinical questions. Among patients receiving OnaBotA, 41.8% were recommended PRT, compared to 18.9% in the non-OnaBotA group (p = 0.010). While the benefit of PRT in the group receiving OnaBotA was 65.4% (n = 17), it was 72.7% (n = 8) in the non-OnaBotA group. These benefits included improvement in the number of attacks, headache days, headache intensity, attack management, headache impact, and disability in the group receiving and not receiving OnaBotA (76.4% and 33.8%, respectively). The findings suggest that PRT is a valuable complementary approach in CM management, particularly for those receiving OnaBotA treatment. Further research should explore standardized protocols for combining these treatments.