Table of ContentsView AllTable of ContentsMigraine HeadachesCervicogenic HeadachesTension HeadachesPossible Risks
Table of ContentsView All
View All
Table of Contents
Migraine Headaches
Cervicogenic Headaches
Tension Headaches
Possible Risks
Certain chiropractic techniques are thought to help ease chronic headaches and migraines. By realigning the spine,chiropractorscan take pressure off nerves and blood vessels, providing relief from headaches andmigraines. In addition tospinal adjustments, chiropractors may recommend lifestyle changes or other therapies to help people find relief from headaches and migraines.
Verywell / Brianna Gilmartin
Chiropractic Treatment of Migraine Headaches
Much of the research exploring the chiropractic treatment of headaches is devoted to migraines. Some studies suggest that around 87% of migraine sufferers report seeing a chiropractor to treat headache pain.
Althoughmigrainesare largely thought to be a neurological condition, studies suggest thatmusculoskeletalconditions like neck pain also contribute. A 2019 study inGlobal Advances in Health and Medicinefound that 75% of people with migraine reported neck pain, stiffness, and tension, often preceding the actual headache.
In response to these and other findings, treatment centers (like the Osher Clinical Center at Brigham and Women’s Hospital in Boston) have begun to integrate chiropractic care into their migraine treatment practices, including:
A 2019 review of studies in the journalHeadacheconcluded that spinal manipulation used for an average of two to six months may be effective in reducing migraine days and pain intensity.
Even so, it is not clear how spinal manipulation helps. Some experts suggest that it may reduce spinalinflammationwhich can set off a migraine attack or that it may stimulate a part of the nervous system called thedescending pain inhibitory system.More research is needed.
Increasingly, chiropractic care—specificallycervical spinal manipulation therapy (SMT)—is being integrated into the treatment plan for cervicogenic headaches.
Cervical SMT involves a technique described as high-velocity, low-amplitude (HVLA) in which rapid force is applied over a small rotational area.
Cervical SMT is typically done when the patient is lying on their back. After supporting the spinal joint with one hand, the chiropractic will tilt the head to itsend range of motionbefore applying HVLA. Variations of the procedure can also performed with the patient lying face down.
A 2020 review of studies in theEuropean Journal of Painreported that cervical SMT provides “superior short-term relief” in the intensity and frequency of cervicogenic headaches but does nothing to reduce the duration of pain episodes.
As with migraine headaches, it is unclear how spinal manipulation helps, though some experts suggest that activation of the descending pain inhibitory system plays a role. Even so, there is little evidence that SMT is more effective than physical therapy in managing cervicogenic headaches.
Tension headachesare the most common type of headache associated with stress and muscle tension in the neck, head, or scalp. Tension headaches cause dull, non-throbbing pain that can feel like a vise around your head or cause all-over head pain worsening at the scalp, temples, or back of the neck.
Unlike cervicogenic headaches, tension headaches can often be effectively treated with over-the-counter pain relievers likeTylenol (acetaminophen)ornon-steroidal anti-inflammatories (NSAIDs)like Advil (ibuprofen) or Aleve (naproxen).
Chiropractic treatment has not proven to be useful in managing this type of headache. With that said, some experts suggest that chronic tension headaches may improve with a multidisciplinary approach involvingstress management,head and neck massage,neck stretching exercises, and myofascial trigger point therapy.
How Often Do You Need a Chiropractor for Headaches?
While chiropractic techniques like spinal manipulation are being increasingly embraced for the treatment of certain headaches, the American Medical Association does not endorse the practice overall and has fought legislation expanding Medicare coverage for chiropractic treatments.
Because of these risks, SMT should not be pursued if you haveosteoporosis, spinal cancer, chronic nerve pain, or a known abnormality in the upper neck. People at an increased risk of stroke should also avoid spinal manipulation.
If suffering from migraines or chronic headaches, it is best to see a healthcare provider first before considering chiropractic treatment. A coordinated approach typically yields the best results.
Summary
12 Sources
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Bernstein C, Wayne PM, Rist PM, Osypiuk K, Hernandez A, Kowalski M.Integrating chiropractic care into the treatment of migraine headaches in a tertiary care hospital: a case series.Glob Adv Health Med.2019 Mar 28;8:2164956119835778. doi:10.1177/2164956119835778
Chaibi A, Benth JŠ, Tuchin PJ, Russell MB.Adverse events in a chiropractic spinal manipulative therapy single-blinded, placebo, randomized controlled trial for migraineurs.Musculoskelet Sci Pract. 2017 Jun;29:66-71. doi: 10.1016/j.msksp.2017.03.003
Rist PM, Hernandez A, Bernstein C. et al.The impact of spinal manipulation on migraine pain and disability: systematic review and meta-analysis.Headache.2019 Mar 14;59(4):532–542. doi:10.1111/head.13501
American Migraine Foundation.What is cervicogenic headache?
Fernandez M, Moore C, Tan J, et al.Spinal manipulation for the management of cervicogenic headache: a systematic review and meta-analysis.Eur J Pain. 2020 Oct;24(9):1687-1702. doi:10.1002/ejp.1632
Ohio State College of Medicine.Cervical manipulation clinical practice guidelines.
Garcia JD, Arnold S, Tetley K, Voight K, Frank RA.Mobilization and manipulation of the cervical spine in patients with cervicogenic headache: any scientific evidence?Front Neurol.2016 Mar 21;7:40. doi:10.3389/fneur.2016.00040
MedlinePlus.Tension headache.
American Medical Association.AMA successfully fights scope of practice expansions that threaten patient safety.
National Center for Complementary and Integrative Health.Spinal manipulation: what you need to know.
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