Application of herbal liniment ( ′Ṭilā ) in the management of pain and disability of chronic migraine: a randomized controlled trial

Objectives Chronic migraine is a prevalent and disabling neurological disorder affecting 1–3 % of the global population. Ancient Unani physicians have described herbal liniment ( ‘Ṭilā ) as a treatment modality for chronic migraine. This study aimed to evaluate its efficacy in managing the condition. Methods A randomized controlled trial was conducted on 36 patients with chronic migraine. Participants were divided into two groups: the test group (n=24), which received herbal liniment applied locally once daily for 15 days, and the control group (n=12), which underwent transcutaneous electrical nerve stimulation (TENS) for 30 min daily, 5 days a week, over 2 weeks. Outcomes were measured using the Visual Analogue Scale (VAS), headache frequency, and the Migraine Disability Assessment Scale (MIDAS) on days 15, 30, 60, and 90. Results Both groups showed significant improvement within the groups in headache frequency (p<0.0001). The test group demonstrated greater effectiveness, with larger reductions in headache frequency (mean difference 39.63; p<0.0001), VAS (mean difference 3.96; p<0.001), and MIDAS (mean difference 2.25; p=0.003). Conclusions Herbal liniment effectively reduced migraine frequency, intensity, and disability. Larger studies are needed to validate these findings and assess long-term outcomes.