Can Chiropractic Help Headaches?

There are many different types of headaches including migraines, cluster, post-traumatic, tension, etc. The most common type of headaches people get is tension headaches, which are a type of primary headache.  There is often an underlying cause of various types of headaches. 

 Tension headaches can affect people of various ages. Although it is common to think of these types of headaches to be caused by stress, that is only one cause. Therefore, people who may not be under tremendous stress, such as children can also get tension headaches. Stress may be thought of as the most common cause. But there are many people who are under significant stress who never get headaches. Factors that influence the muscles of the neck and head can also cause tension headaches. These factors include, injury to the muscles, such as in a trauma or repetitive strain injuries, which may often be work-related. Poor posture also places the muscles of the neck and head under increased strain. Poor posture has been shown to be related to the presence of headaches.1 

 The brain itself does not produce pain signals, as it does not have nerve receptors sensitive to painful stimuli. However, the blood vessels and nerves within the head can produce pain signals, as can the muscles and meninges (layer of tissue covering the brain and spinal cord). The exact physiology of the mechanisms producing the pain is not well understood. Some headaches, such as migraines and cluster headaches begin in the brain with neurologic dysfunction and subsequent blood vessel response. Others such as the common tension-type headache, can begin with a similar central neurologic mechanism, or can start with over activity of the muscles of the head and neck due to injury (for example after a “whiplash”), poor posture, stress or prolonged repetitive neck movement as seen in work related repetitive strain injuries. 

 Headaches are very elusive to accurate diagnosis. A careful history must be done. Headache questionnaires are very common and often a doctor may ask you to keep a “headache diary” keeping note of the duration, frequency, and type of headache, in addition to possible triggering factors, such as stressful events, foods or activities. Sometimes a Computed Tomography (CT) scan of the head is done. This is more precautionary to rule out more serious pathology. In a few cases MRI examination of the head and/or neck may be ordered. X-rays of the neck are often recommended to evaluate the possibility of production of the problem within the neck that could be leading to the production of headache symptoms. 

 Headaches are a neurological problem. Sometimes this neurological production of pain starts from a spinal joint issue. The vertebrae of the spine contain and protect the spinal cord and spinal nerves. Chiropractic Biophysics® care works to improve the function of the nervous system and muscular function by restoring normal structure to the spine and posture through the use of Mirror Image exercises, traction and adjusting. 

“Analgesics”, or pain relieving medications, are often used by headache sufferers.  However, these drugs merely hide the symptoms and do nothing to improve the underlying cause of the headaches. Regular use of these over-the-counter and prescription medications can lead to “rebound headaches” which are actually worse that the original headache they intended to relieve. Medications implicated in rebound headaches include nonprescription painkillers, such as acetaminophen, aspirin, and ibuprofen. Prescriptions such as barbiturates, sedatives, narcotics, and migraine medications, particularly those that also contain caffeine can also lead to rebound headaches. Heavy caffeine intake use can also cause this condition. Typical medical intervention rarely addresses the “cause” of the tension-type headaches. 

 Original research studies and review articles have shown the potential benefits of chiropractic care. In fact, 10 Randomized Clinical Trials (RCT’s) have reported significant improvement with chiropractic care for tension-type headaches and other headaches with neck related complaints in the majority of studies.2-11 See Table 1. Millions of headache sufferers have found amazing relief from chiropractic care. Call our office today to schedule a free consultation so we can find out if there is a way we can help you with your headaches. 

 Table 1. 10 Randomized Clinical Trials of tension headaches and headaches with neck symptoms with majority of studies showing positive effects of chiropractic care 

Headaches RCTs   




# Treated patients 


# visits 

Pain: NRS VAS/10 


Treatment by DC, MD, DO, PT?   

SMT or Other 

Boline et al, 19952  Tension HA  70  12  2.8/2.15 ratio  DC  SMT/heat/ 


Bove, Nilsson, 19983  Tension HA  36  8  3.7/3.8  DC  SMT/soft tissue 
Donkin et al, 20024  Tension HA  15,15  9  4.03/1.47 & 


DC  SMT vrs SMT/Traction 
Haas et al, 20045  HA, Neck Pain  7, 






HA :5.14/4.05  

HA: 6.12/3.13  

HA: 4.5/1.87  

Hemmilia et al, 20056  HA,NP,UBP  22  5  5.06/1.85  Bone Setter  SMT 
Hoyt et al, 19797  Tension HA  10  1  5.4/2.9 ratio  DO  Osteopath SMT 
Jull et al, 20028  Cervico-genic HA  49,51,51  8-12  5.1/1.8  PT  SMT/Maitland/ 


Nilsson, 19959  Chronic HA  20  6  4.7/2.7  DC  SMT/Diversif 
Nilsson, 1996-9710  HA  28  6  4.4/2.8  DC  Toggle/Divers 
Whittingham  et al, 200111  Cervicogenic HA  49 




NR  DC  Toggle = SMT 



  1. Mingels S, Dankaerts W, van Etten L, Thijs H, Granitzer M. Comparative analysis of head-tilt and forward head position during laptop use between females with postural induced headache and healthy controls. J Bodyw Mov Ther. 2016 Jul;20(3):533-41 
  1. Boline PD, Kassak K, Bronfort G, Nelson C, Anderson AV. Spinal manipulation vs. amitriptyline for the treatment of chronic tension-type headaches: a randomized clinical trial. J Manipulative Physiol Ther. 1995;18:148-154. 
  1. Bove G, Nilsson N. Spinal manipulation in the treatment of episodic tension-type headache: a randomized controlled trial. JAMA. 1998;280:1576-1579. 
  1. Donkin RD, Parkin-Smith GF, Gomes AN. Possible effect of chiropratic manipulation and combined manual traction and manipulation on tension-type headache: a pilot study. J Neuromusculoskeletal Syst. 2002;10:89-97. 
  1. Haas M, Haas M, Groupp E, Aickin M, Fairweather A, Ganger B, Attwood M, Cummins C, Baffes L. Dose response for chiropractic care of chronic cervicogenic headache and associated neck pain: a randomized pilot study. J Manipulative Physiol Ther 2004;27:547-55 
  1. Hemmila HM. Bone setting for prolonged neck pain: a randomized clinical trial. J Manipulative Physiol Ther 2005;28(7):508-15. 
  1. Hoyt WH, Shaffer F, Bard DA, Benesler JS, Blankenhorn GD, Gray JH, et al. Osteopathic manipulation in the treatment of muscle-contraction headache. J Am Osteopath Assoc. 1979;78:322-5.  
  1. Jull G, Trott P, Potter H, et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine 2002;27:1835-1843; discussion 1843. 
  1. Nilsson N. A randomized controlled trial of the effect of spinal manipulation in the treatment of cervicogenic headache. J Manipulative Physiol Ther 1995;18:435-440. 
  1. Nilsson N, Christensen HW, Hartvigsen J. Lasting changes in passive range of motion after spinal manipulation: A randomized, blind, control trial. J Manipulative Physiol Ther. 1996;19:165-168. 
  1. Whittingham W, Nilsson N. Active range of motion in the cervical spine increases after spinal manipulation (toggle recoil). J Manipulative Physiol Ther 2001;24(9):552-5. 



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