Headache Treatments

Headaches are one of the most common conditions that cause people pain. Headaches can vary from cluster, migraine, tension, or cervicogenicheadaches. In addition, we can classify headaches as acute or chronic. They can be episodic as in happening once in a great while. Or they can last for several straight days in a row such as with migraine headaches.

Treatment recommendations and practices vary between clinics. As with any condition it is always patient specific, butt we do see patterns on how people tend to respond. The below study looked to collect informationon various studies to determine what is the best type of treatment for each headache subset.

Migraine and episodic headaches showed benefit from chiropractic and a multidisciplinary approach of heat, electric, stretching, exercise, and massage therapy. People responded very well to these type of treatments. Inaddition people with cervicogenicheadaches responded very wellto chiropractic treatments and also deep neck flexor exercises.However combining the two treatments did not show additional benefit. For pure tension type headaches manipulation by itself could not be recommended for tension type headaches. Joint mobilization and movements did show benefit to those tension type headaches.

As with some of the other studies, we are seeing benefits of chiropractic and combination of physical therapy modalities for headache treatment protocols. Each headache conditionbenefits from different types of treatments. A variation of treatment type should be applied to see what the patient responds best to. Looking at patients with tension type headaches, manipulation by itself may not be the best answer. However combining this with other soft tissue, myofascialtreatments, Graston Technique, massage therapy, stretching, and posture changes early in treatment and throughout would shows benefit. Graston Technique is very beneficial at breaking up scar tissue and fascialrestrictions within muscles and tendons that contribute to postural headaches

Once again we are seeing that not every headache is the same. And not every treatment will work on every type of headache. Seeking a provider who combines different types of treatments and has different treatment options in the office appears to be the most beneficial for patient outcomes.

Study is listed below if you’d like more reading information. Massage Therapy or Graston Technique can help improve headache symptoms. More information on therapeutic treatments utilizing Physical Therapy or Chiropractic can bedirected to Google+.

Journal of Manipulative and Physiological Therapeutics
Volume 34, Issue 5 , Pages 274-289, June 2011

Evidence-Based Guidelines for the Chiropractic Treatment of Adults With Headache

Roland Bryans, DC, Martin Descarreaux, DC, PhD, MireilleDuranleau, DC, and et al.



The purpose of this manuscript is to provide evidence-informed practicerecommendations for the chiropractic treatment of headache in adults.


Systematic literature searches ofcontrolled clinical trials published through August 2009 relevant to chiropractic practice were conducted using the databases MEDLINE; EMBASE; Allied and Complementary Medicine; the Cumulative Index to Nursing and Allied Health Literature; Manual, Alternative, and Natural Therapy Index System; Alt HealthWatch; Index to Chiropractic Literature; and the Cochrane Library. The number,quality, and consistency of findings were considered to assign an overall strength of evidence (strong, moderate, limited, or conflicting) and to formulate practice recommendations.


Twenty-one articles met inclusion criteria and were used to develop recommendations. Evidence did not exceed a moderate level. For migraine, spinal manipulation and multimodal multidisciplinary interventions including massage are recommendedfor management of patients with episodic or chronic migraine. For tension-type headache, spinal manipulation cannot be recommended for the management of episodic tension-type headache. A recommendation cannot be made for or against the use of spinal manipulation for patients with chronic tension-type headache. Low-load craniocervicalmobilization may be beneficial for longer term management of patients with episodic or chronic tension-type headaches. For cervicogenicheadache, spinal manipulation is recommended. Joint mobilization or deep neck flexor exercises may improve symptoms. There is no consistently additive benefit of combining joint mobilization and deep neck flexor exercises for patients with cervicogenicheadache. Adverse events were not addressed in most clinical trials; and if they were, there were none or they were minor.


Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenicheadaches. The type, frequency, dosage,and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal. PubMed