How Chiropractic Therapy May Ease Headaches and Migraines

The benefit of chiropractic therapies depends on the type of headache

Will a Chiropractic Massage Help My Headaches?
Will a Chiropractic Massage Help My Headaches?. Scott Stulberg/Getty Images

You have probably heard of chiropractors ​performing spinal manipulation or massage for people with headaches—but do these treatments work? Based on scientific evidence, some of them do, but it depends on the type of headache disorder a person has.

Which Chiropractic Therapies Ease Migraines

Scientific research suggests that chiropractic therapies like massage and spinal manipulation can be helpful in managing migraines, both episodic and chronic.

When you think of a massage, you probably think of a Swedish massage—the most conventional type of massage that entails muscle kneading, rolling, and application of deep pressure.

For migraines, weekly neuromuscular massages that focus on trigger points within the back, shoulder, neck, and head have been found to be helpful. The purpose of this type of massage is to soothe tight muscles where nerves may be compressed, release knots (trigger points) in muscles believed to be the source of pain, and provide good blood flow to the muscles to keep them healthy.

Spinal manipulation entails a chiropractor or other trained healthcare professional like a physical therapist or osteopathic doctor using their hands or a device to apply a controlled force to a specific joint of the spine. When this force is applied, a person may hear a popping sound. For headaches, the cervical spine (neck) is the region of the spine that a chiropractor focuses on.

Sessions of spinal manipulation for a person with migraine may occur one to two times weekly for two months.

Unlike massage which is generally a safe, harmless therapy, there are some serious risks associated with spinal manipulation of the upper spine. These risks include:

  • stroke
  • bleeding
  • disc herniation
  • nerve compression

This is why it is important to carefully discuss any treatments you are considering first with your primary care doctor or headache specialist.

In addition to massage and spinal manipulation for migraines, a multidisciplinary care intervention that 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. Interestingly, exercise used alone (whether it's aerobic exercise, neck range of motion exercises, or whole body stretching) has not been conclusively shown to be beneficial in people with migraines.

This suggests that it's the combination of therapies that eases migraines—a more holistic approach, one that considers the body, mind, and a person's lifestyle.

Which Chiropractic Therapies Ease Tension-Type Headaches

For episodic tension-type headaches ​(those gripping, tight headaches), spinal manipulation has not been found to be helpful.

That being said, spinal manipulation may be helpful for people who have chronic tension-type headaches, although the scientific evidence examining this is still inconclusive.

One chiropractic therapy that can be effective in treating both episodic and chronic tension-type headaches is low-load craniocervical mobilization. In this intervention, a gentler force than that used in spinal manipulation is applied to the joints of the neck, allowing for rhythmic movement of the cervical segments. Stretching is also usually part of this intervention.

In one study in Cephalalgia, the Thera-Band resistive exercise system (a form of craniocervical mobilization) was found to reduce tension-type headache frequency, intensity, and duration. Participants performed the exercises daily for six weeks followed by bi-weekly exercises for 6 months. The results of this study (6 months) are promising in that this intervention offered relief throughout the entire duration of the course of therapy.

Which Chiropractic Therapies Ease Cervicogenic Headaches

Cervicogenic headache, an uncommon type of headache, is believed to stem from an underlying neck problem. People with cervicogenic headaches often describe a one-sided head pain that starts at the back of the head and then moves to the front. It is also usually associated with same-sided, diffuse shoulder and arm pain. The pain is worsened with either external pressure or certain positioning of the neck for a prolonged period of time.

Spinal manipulation is recommended for cervicogenic headache, two times weekly for three weeks while joint mobilization in the neck is recommended for eight to twelve sessions over 6 weeks. Deep neck flexion exercises may also ease symptoms of cervicogenic headache but need to be done daily for six weeks.

An example of a deep neck flexion exercise is one in which a person lies flat on the floor and does a series of chin tucks followed by nodding of the head. These exercises (muscle contractions) are usually done for ten-second intervals followed by ten seconds of rest for 15 repetitions. Ultimately, these exercises stretch the longus capitis and colili, the deep neck flexor muscles​ that play an important role in supporting the neck.

A Word From Verywell

Treating your migraine or headache disorder is a challenging task. But by working with your doctor, keeping an open-mind, and trusting your instincts, you are already off to a good start. In the end, 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.

Sources:

Borisut S, Vongsirinavarat M, Vachalathiti R, Sakulsriprasert P. Effects of Strength and Endurance Training of superficial and deep neck muscles on muscle activities and pain levels of females with chronic neck pain. J Phys Ther Sci. 2013 Sep; 25(9):1157-62.

Bryans R et al. Evidence-based guidelines for the chiropractic treatment of adults with headache. J Manipulative Physiol Ther. 2011 Jun;34(5):274-89.

Ernst E. Adverse effects of spinal manipulation: a systematic review. J R Soc Med. 2007 Jul;100(7):330-38.

Fredrikesen TA, Antonaci F, Sjaastad O. Cervicogenic headache: too important to be left un-diagnosed. J Headache Pain. 2015;16:6.

van Ettekoven H, Lucas C. Efficacy of physiotherapy including a craniocervical training programme for tension-type headache; a randomized clinical trial. Cephalalgia. 2006 Aug;26(8):983-91.

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