Chiropractic for Headaches and Migraine

Chiropractic care, including a combination of chiropractic, active and passive exercise, and massage, is often used for headache management and prevention. Although chiropractic is popular, there is limited evidence on its effectiveness for most headache types, and there are potential adverse consequences of chiropractic.

Guidelines for the use of chiropractic for headaches have emerged, and many studies are underway. The types of headaches that often seek chiropractic treatment — cervicogenic, migraine, and tension headaches — respond differently to chiropractic.

for cervicogenic headache

Cervicogenic headaches usually start with pain on one side, starting at the back of the head and moving to the front, usually with pain in the shoulder or arm on the same side. Cervicogenic headaches are thought to stem from an underlying neck problem and can be triggered by injury.

Cervicogenic headaches are one of the least common types of headaches and usually don’t improve with medication. This is the only type of headache for which spinal manipulation is recommended.

Chiropractic options for cervicogenic headaches include:

Spinal manipulation: This is a procedure in which healthcare providers trained in spinal manipulation use their hands or equipment to apply controlled forces to specific joints in your spine. You may hear a popping sound when force is applied.

When using spinal manipulation to treat cervicogenic headaches, the cervical spine (the upper part of the spine in the neck) is the area of ​​focus.

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Most adverse reactions are mild and transient, but there are some serious risks associated with spinal manipulation of the upper spine to consider, including:

  • stroke
  • bleeding
  • Disc herniation
  • nerve compression
  • Anatomy (tear in the posterior or anterior carotid artery)

Joint mobilization: A therapy that passively moves a joint to improve movement or reduce pain. When used for headaches, this treatment targets the cervical spine.

Deep neck flexion exercises: These exercises involve actively moving your muscles and joints under the guidance of a healthcare professional.

An example of a deep neck flexion exercise is where you lie flat on the floor and perform a series of jaw clenching and then nodding. These muscle contractions usually last 10 seconds apart, followed by a 10 second rest, and repeat 15 times.

Ultimately, the goal is to stretch the deep neck flexors that are important for supporting the neck.


Migraine is characterized by a headache, along with other symptoms such as dizziness and nausea. There are some effective medications available to prevent migraine or acute migraine attacks. Some procedures, such as pain relief injections, have also been successful.

Migraine headaches are often associated with neck pain, which makes it difficult to differentiate between migraines and cervicogenic headaches. It is important to ask your healthcare provider to investigate the root cause and determine the best management plan.

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Chiropractic is not one of the most effective or commonly recommended options for migraines, but some types of chiropractic may be effective.

Chiropractic options for migraine headaches include:

Neuromuscular Massage: Also known as trigger point therapy, this massage focuses on trigger points in the back, shoulders, neck, and head to relax muscles, improve blood flow, and even relieve stress. This can relieve symptoms by releasing the pressure on the compressed nerves that send pain signals to the brain.

Multidisciplinary Nursing Intervention: This approach, which combines physical therapy exercises, relaxation techniques, stress management, and dietary counseling, has been found to be effective in reducing migraine pain, frequency, duration, and disability.

Foods That Trigger Migraine

For tension headaches

Episodic tension headaches are common. They can be muscle tension due to chronic tension in the neck, shoulders, or head, often relieved by over-the-counter pain relievers such as non-steroidal anti-inflammatory drugs (NSAIDs) or Tylenol (acetaminophen) improve.

Chiropractic therapy, including chiropractic, has not been found to help with this type of headache. However, chronic tension headaches can be improved with a multidisciplinary approach that includes soft tissue therapy (eg, trigger point therapy, stretching) and stress management.

Other chiropractic treatments that may be helpful include:

Low-load cranio-cervical mobilization: This involves gentler force than spinal manipulation. For the treatment of headaches, this force is applied to the neck joints, allowing rhythmic movements of the neck segments. Stretching is often part of this intervention as well.

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Consult your healthcare provider if you are interested in complementary and alternative (CAM) therapy for headaches. A combination of treatments may ease your headaches—finding the right combination takes some patience, persistence, and some trial and error.

Frequently Asked Questions

  • Can chiropractic help with migraines?

    Possibly, but there isn’t a lot of strong scientific evidence to support chiropractic adjustments for migraine. A study of 104 migraine sufferers compared chiropractic with sham treatment or medication and found no benefit from chiropractic compared to placebo.

  • Do chiropractors treat tension headaches?

    Yes, chiropractors treat tension headaches. However, spinal adjustments may not help. The good news is that other chiropractic treatments can relieve chronic tension headaches. This includes trigger point therapy, stretching and stress management strategies.

  • Can chiropractic help with headaches?

    Yes, but not all types of headaches. Research shows that chiropractic is best for cervicogenic headaches. Cervicogenic headaches start with pain on one side of the head, start in the back and move to the front of the head, and may include shoulder or arm pain. Spinal manipulation seems to help relieve this, which is suspected to be caused by an underlying neck problem or injury.