Brain & Nervous System Migraines Treatment Chiropractic Therapy for Headaches and Migraines The benefit of chiropractic therapies depends on the type of headache By Colleen Doherty, MD Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis. Learn about our editorial process Colleen Doherty, MD Medically reviewed by Medically reviewed by Claudia Chaves, MD on June 01, 2020 Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. She is an associate professor of neurology at Tufts Medical School and medical director of the Lahey Clinic Multiple Sclerosis Center in Lexington, Massachusetts. Learn about our Medical Review Board Claudia Chaves, MD on June 01, 2020 Print Table of Contents View All For Cervicogenic Headaches For Migraines For Tension Headaches Chiropractic care, which includes a combination of spinal manipulation, active and passive exercises, and massage, is often used for headache management and prevention. While chiropractic treatment is popular, there is limited evidence regarding its effectiveness for most headache types, and there are potential adverse outcomes of spinal manipulation. Verywell / Brianna Gilmartin Guidelines regarding the use of chiropractic care for headaches have emerged, with a number of research studies underway. The headache types for which chiropractic therapy is often sought out—cervicogenic headaches, migraines, and tension headaches—each respond differently to chiropractic treatment. For Cervicogenic Headaches Cervicogenic headaches typically begin with one-sided pain that starts at the back of the head and then moves to the front, often with accompanying same-side shoulder or arm pain. Cervicogenic headaches are believed to stem from an underlying neck problem and may be triggered by an injury. Cervicogenic headaches, which are among the least common headache types, often don't improve with medication. This is the only headache type for which spinal manipulation is recommended. Chiropractic therapy options for cervicogenic headaches include: Spinal manipulation: This is a procedure in which a healthcare provider who is trained in spinal manipulation uses their hands or a device to apply a controlled force to a specific joint of your spine. You may hear a popping sound when the force is applied. The cervical spine (upper part of the spine in the neck) is the region of focus when spinal manipulation is used for treating cervicogenic headaches. Most adverse effects are mild and short-lived, but there are also are some serious risks associated with spinal manipulation of the upper spine that should be considered, including: StrokeBleedingDisc herniationNerve compressionDissection (tearing of the artery in the back or front of the neck) Joint mobilization: A type of therapy in which your joints are passively moved for the purpose of improving movement or reducing pain, this treatment targets the cervical spine when used for headaches. 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 one in which you lie flat on the floor before doing a series of chin tucks, followed by nodding your head. These muscle contractions usually last for 10-second intervals followed by 10 seconds of rest for 15 repetitions. Ultimately, the goal is to stretch the deep neck flexor muscles that play an important role in supporting the neck. For Migraines Migraines are characterized by headaches, as well as other symptoms, such as dizziness and nausea. There are effective medications that can be used for migraine prevention or for acute migraine episodes. Some procedures, such as pain injections, have also been successful. Chiropractic treatment is not among the most effective or commonly recommended options for migraines, but there are some types of chiropractic therapies that may be effective. Chiropractic therapy options for migraines include: Neuromuscular massage: Massage with a focus on trigger points within the back, shoulder, neck, and head may ease symptoms. Multidisciplinary care 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 Migraines For Tension Headaches Episodic tension headaches are very common. They can result from muscle tension due to prolonged tension in the neck, shoulders, or head, and they generally improve with over-the-counter pain medications, such as non-steroidal anti-inflammatories (NSAIDs) or Tylenol (acetaminophen). Chiropractic treatment, including spinal manipulation, has not been found to be helpful. However, chronic tension headaches may improve with modified chiropractic therapy. Chiropractic therapy options for tension headaches include: Low-load craniocervical mobilization: This involves a gentler force than that used in spinal manipulation. For treatment of headaches, this force is applied to the joints of the neck, allowing for rhythmic movement of the cervical segments. Stretching is also usually part of this intervention. A Word From Verywell If you are interested in complementary and alternative (CAM) therapies for your headaches, talk with your doctor. It's likely that a combination of therapies will ease your headache pain—and finding that right combination will require some patience, persistence, and a little trial and error. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. 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. Epub 2017 Mar 14. Haas M, Bronfort G, Evans R, et al. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine J. 2018;18(10):1741-1754. doi:10.1016/j.spinee.2018.02.019 Posadzki P, Ernst E. Spinal manipulations for the treatment of migraine: a systematic review of randomized clinical trials. Cephalalgia. 2011;31(8):964-70. doi:10.1177/0333102411405226 Additional Reading Bryans R, Descarreaux M, Duranleau M, et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther. 2011 Jun;34(5):274-89. doi: 10.1016/j.jmpt.2011.04.008. Chaibi A, Knackstedt H, Tuchin PJ, Russell MB. Chiropractic spinal manipulative therapy for cervicogenic headache: a single-blinded, placebo, randomized controlled trial. BMC Res Notes. 2017 Jul 24;10(1):310. doi: 10.1186/s13104-017-2651-4. Chaibi A, Russell MB. Manual therapies for primary chronic headaches: a systematic review of randomized controlled trials. J Headache Pain. 2014 Oct 2;15:67. doi: 10.1186/1129-2377-15-67.