Non-Pharmacological Migraine Care in India: A Critically Appraised Narrative Review

Migraine is a highly prevalent and disabling neurological disorder that affected an estimated 2.9 billion people worldwide in 2023 and remains a leading contributor to global disability. In India, population-based surveys report a one-year prevalence of approximately 25 per cent in some states, underscoring its scale as a public health concern. This narrative review critically appraises the evidence for non-pharmacological approaches to migraine care, including neuromodulation, behavioural therapies, and digital health technologies, and considers their feasibility within the Indian health system. Several modalities show meaningful benefit: remote electrical neuromodulation demonstrates moderate-certainty efficacy for both acute and preventive migraine care, and yoga is associated with significant reductions in headache frequency and migraine-related disability across independently conducted Indian trials. Substantial barriers nonetheless constrain scale-up in India, including the high cost of neuromodulation devices and a shortage of personnel trained to deliver behavioural interventions. Migraine remains excluded from national non-communicable disease policy despite its considerable burden. Realising the public-health potential of non-pharmacological migraine care in India will require dedicated research investment, equitable access strategies, and formal recognition of migraine within national health policy.