Therapeutic evaluation of herbal poultice (Ḍimād) in the management of pain and disability of chronic migraine: A case report.

BACKGROUND

Chronic migraine ('Shaqīqa-i-Muzmin) is a common and disabling neurological condition affecting 1-3% of the global population. Esteemed Unāni physicians documented the use of an herbal poultice (Ḍimād) for treating chronic migraine. This case report describes the clinical outcomes of a patient with chronic migraine treated with a herbal poultice (Ḍimād).

CASE PRESENTATION: A 45-year-old female presented to the Outpatient Department of Ilāj bi'l Tadbīr at Kashmir Tibbia College Hospital and Research Centre in Kashmir, India, with a 12-year history of chronic migraine. She experienced recurrent unilateral, throbbing headaches accompanied by nausea, photophobia, and phonophobia, occurring on approximately 18 days per month. Prior conventional treatments provided only temporary symptomatic relief. At baseline, her Visual Analogue Scale (VAS) score was 8/10, and her Migraine Disability Assessment Scale (MIDAS) score was 42, indicating severe disability.

INTERVENTION AND OUTCOMES: The patient received treatment with an Ḍimād composed of Euphorbia resinifera Berg. (Farfiyūn), Ferula foetida Regel (Hiltīt), and Ferula galbaniflua Boiss. (Jāwshīr), prepared in sugarcane vinegar. The formulation was applied once daily to the forehead and right frontotemporal region for 28 consecutive days. After treatment, headache frequency dropped from 18 to 4 days per month, the VAS score improved from 8 to 2, and the MIDAS score decreased from 42 to 10. Associated symptoms were significantly reduced. No adverse events occurred, treatment adherence was excellent, and clinical improvement persisted throughout the six-month follow-up period.

CONCLUSION

This case suggests that Ḍimād may be a safe and potentially beneficial complementary therapeutic option for chronic migraine. Additional controlled studies are needed to validate its efficacy and safety.