Chronic migraine represents an incapacitating neurological disorder that affects millions of people all over the world. The purpose of the study was to evaluate the effectiveness of the combined osteopathic medicine and physical treatment interventions in managing chronic migraines. In a randomized controlled trial 120 patients with chronic migraine were randomized to treatment, comprising a 12-week osteopathic manipulative treatment (OMT) followed by physical therapy or control - receiving standard care. The intervention group had a greater decline in migraine frequency (mean difference: -4.2 days/month, p<0.001) and intensity (mean difference in 0-10 scale: -1.8, p<0.001) than the control group. Further, the participants in the intervention group had significant enhancements in quality of life and significant reductions in the intake of medication. As such, it is feasible to conclude that the combined therapy with osteopathy and physical therapy could be a beneficial addition in chronic migraine management which provides an alternative to medications for patients and health care professionals.