Active meditative techniques appear to be more effective at reducing migraine severity than distraction techniques, according to research published in the journal Complementary Therapies in Medicine.

“Meditation practice has been associated with improved pain and decreased migraine headaches frequency in previous studies,” the authors of the new study said. “However, it is unknown if all forms of cognitive control, both those that contain meaningful practices for the participant (e.g. meditation, relaxation) and meaningless practices (e.g. simple distraction) would be equally effective in reducing migraine headache frequency or pain levels.”

The researchers re-analyzed data from a previous study on migraines and meditation, in which 83 individuals with frequent migraines were instructed to practice spiritual meditation, internally-focused secular meditation, externally-focused secular meditation, or progressive muscle relaxation. The participants also completed daily headache diaries.

The meditation practices were fairly simple. It consisted of focusing on a phrase for 20 minutes per day for 30 days.

“Meditation participants were instructed to begin their meditation by softly repeating their meditation aloud a few times to help them focus, and then to continue to silently focus on the phrase, and how the phrase is reflected in their lives. If the participants felt they were losing focus, they should repeat the phrase aloud to refocus and then continue with the silent meditation,” the authors of the original study explained.

For spiritual meditation, participants were instructed to focus on spiritual phrases such as “God is peace.” For internally-focused secular meditation, participants were instructed to focus on positive self-reinforcement phrases such as “I am good.” For externally-focused secular meditation, participants were instructed to focus on phrases such as “Grass is green.”

Those in the progressive muscle relaxation group, meanwhile, were taught cognitive techniques to reduce muscle tension, which they also practiced for 20 minutes per day for 30 days.

The researchers considered externally-focused meditation to be a form of cognitive distraction, while the other three practices were meaningfully focused on spirituality, self-esteem, or one’s own body — and thus considered active.

The authors of the study found a significant decrease in self-reported migraine pain over the course of 30 days, but only among those practicing the active techniques. The most significant change occurred after 20 days of practice.

“Simple cognitive distraction techniques, such as mental distractions with phrases that do not provide cognitive or physical stress management, may reduce immediate migraine headache pain, but may have limited long-term impact on migraine headache pain or negative mood. However, when practiced 20 min per day for at least 20 days, active cognitive-focus techniques using meaningful practices among frequent migraineurs may effectively reduce migraine headache pain,” the researchers concluded.

The study, “A reanalysis of a randomized trial on meditation for migraine headaches: Distraction is not enough but meditation takes time“, was authored by Amy Wachholtz, Rini Vohra, and Aaron Metzger.