To evaluate the efficacy of a single, individualized mindfulness breathing intervention on the reduction of perceived migraine pain during a single office visit.

Mindfulness breathing exercises and behavioral interventions are recognized as useful techniques in the treatment and prevention of migraine headaches.  Randomized-controlled trials on the use of mindfulness, meditation or breathing exercises as preventive treatment strategies for migraines have demonstrated efficacy in perceived pain reduction, acceptance of pain, and in reduction of migraine attacks. However, the use of these modalities as an acute intervention during an office visit has not been explored.

Patients presenting to the outpatient Neurology clinic at Naval Medical Center San Diego were offered a single, therapist-guided session of mindfulness-based stress reduction with breathing techniques if experiencing migraine pain.  They were assessed for pre- and post-intervention self-reported pain level (scaled from 1-10), Headache Impact Score (HIT-6), PHQ-9 Patient Depression Questionnaire and maintenance of full active duty status without medical board. 

Ninety-seven patients were screened and evaluated for migraine headaches.  Fourteen elected to participate in a single session of guided mindfulness.  Participants were all actively enduring migraine pain during the office visit and were assessed for pre- and post-intervention pain scales.  Of the 14 patients assessed, 12 had a reduction in pain.  On average, pain scale was reduced by 3.4 points. No patients had an increase in pain scores. 

The use of guided mindfulness breathing techniques has not been explored as an abortive treatment strategy for migraine headaches.  During a Neurology clinic visit, a single session of guided mindfulness resulted in immediate reduction of perceived pain for 86% of patients.  Despite the small sample size, this pilot study suggests a possible safe, impactful intervention for patients with medication-resistant migraines.