Chiropractic for Headaches & Migraines | Perth Chiropractor

Published March 1, 2026 | By Bateman Chiropractic

Understanding Headaches: How Chiropractic Care May Help Manage Certain Types

Could neck dysfunction be contributing to your headaches?

Headaches are among the most common health complaints in Australia, affecting approximately 15% of the population on any given day (Australian Institute of Health and Welfare, 2022). While headaches have numerous potential causes, research suggests that musculoskeletal factors—particularly those involving the neck and upper spine—may play a significant role in certain headache types.

The Burden of Headaches in Australia

According to Headache Australia, headache disorders cost the Australian economy approximately $35.7 billion annually in healthcare costs and lost productivity (Migraine & Headache Australia, 2018). Common impacts include:

Reduced work productivity and missed workdays
Decreased quality of life and social participation
Reliance on pain medications
Effects on mental health and wellbeing
Disrupted sleep patterns

While many headache sufferers rely solely on medication, research suggests that for certain headache types, addressing musculoskeletal factors may provide additional benefits.

Understanding Different Headache Types

The International Classification of Headache Disorders (ICHD-3) recognizes over 200 different types of headaches. However, several types are most commonly seen in chiropractic practice:

Cervicogenic Headaches

These headaches originate from dysfunction in the cervical spine (neck). Research published in Cephalalgia indicates that cervicogenic headaches account for approximately 15-20% of chronic headaches (Bogduk & Govind, 2009).

Characteristics often include:

Pain starting from the neck and radiating to the head
Usually one-sided (unilateral) pain
Reduced neck range of motion
Headache triggered or worsened by neck movements or sustained postures
Pain in neck, shoulder, or arm on the same side

Tension-Type Headaches

The most common headache type, tension-type headaches affect up to 38% of the population annually (Stovner et al., 2007). While the exact mechanisms are debated, muscular factors and cervical spine dysfunction may contribute in some cases.

Common features include:

Bilateral (both sides) pressure or tightness
Mild to moderate intensity
Not typically worsened by routine physical activity
May be associated with neck and shoulder muscle tenderness

Migraine Headaches

Migraines affect approximately 12% of Australians and are a leading cause of disability worldwide (GBD 2016 Headache Collaborators, 2018). While migraines are primarily neurological in nature, cervical spine factors may influence migraine frequency and intensity in some individuals.

Migraine features include:

Moderate to severe throbbing pain
Often one-sided
Nausea, vomiting, or sensitivity to light and sound
Worsened by physical activity
May include aura (visual or sensory disturbances)

Important Note: Not all headaches are appropriate for chiropractic care. Serious underlying conditions must be ruled out, and some headache types require medical management.

What Does Research Say About Chiropractic Care for Headaches?

Cervicogenic Headaches

The evidence for manual therapy approaches to cervicogenic headaches is relatively robust. A Cochrane systematic review examining manual therapies for adults with headaches found moderate-quality evidence supporting spinal manipulation and mobilization for cervicogenic headaches (Bronfort et al., 2004).

More recent research published in The Spine Journal conducted a randomized controlled trial with 256 participants experiencing cervicogenic headaches. The study compared spinal manipulation, medication, and a control group. Findings suggested that spinal manipulation provided similar pain relief to medication in the short term, with some participants experiencing sustained benefits (Haas et al., 2010).

A systematic review in Manual Therapy analyzed multiple studies and concluded that there is moderate evidence supporting manual therapy techniques for reducing pain intensity and frequency in cervicogenic headaches, though individual responses vary (Racicki et al., 2013).

Tension-Type Headaches

Evidence for tension-type headaches is more mixed. A systematic review published in Journal of Manipulative and Physiological Therapeutics examined trials of spinal manipulation for tension-type headaches. The authors concluded that spinal manipulation may be as effective as first-line medications like amitriptyline, though more high-quality research is needed (Bryans et al., 2011).

A randomized controlled trial in European Journal of Neurology compared manual therapy with usual care for chronic tension-type headaches. The manual therapy group showed statistically significant improvements in headache frequency and intensity, though the clinical significance was modest (Castien et al., 2011).

Important Context: While these studies show promise, they generally demonstrate modest effects, and not all patients respond to treatment. Results should be interpreted cautiously, and individual outcomes vary.

Migraine Headaches

Research on chiropractic care for migraines is less conclusive. A systematic review in Cephalalgia examined spinal manipulative therapy for migraine prevention. The review found some evidence of potential benefit, but noted significant methodological limitations in existing studies and called for more rigorous research (Chaibi & Russell, 2014).

A more recent trial published in European Journal of Neurology compared spinal manipulation to a sham procedure and medication for migraine prevention. The study found that spinal manipulation showed similar effectiveness to medication in reducing migraine days, though results were modest and individual responses varied considerably (Chaibi et al., 2017).

Critical Assessment: While some migraine sufferers may benefit from chiropractic care, we cannot claim that chiropractic treats or cures migraines. Any benefits are likely modest and complementary to medical management.

Mechanisms: How Might Chiropractic Care Affect Headaches?

Several proposed mechanisms may explain how manual therapy could influence certain headaches:

Improved Cervical Joint Mobility

Research suggests that joint dysfunction in the upper cervical spine may contribute to headache development. Spinal manipulation may restore normal joint mechanics and reduce mechanical stress on pain-sensitive structures (Biondi, 2005).

Reduced Muscle Tension

Studies using electromyography (EMG) have shown that manual therapy techniques can reduce muscle tension in cervical and shoulder muscles, which may be relevant for tension-type and cervicogenic headaches (Vernon et al., 2009).

Modulation of Pain Processing

Research indicates that spinal manipulation may influence central pain processing mechanisms, potentially affecting how the nervous system interprets pain signals. This effect has been demonstrated in experimental pain studies, though clinical relevance requires further investigation (Bialosky et al., 2009).

Improved Blood Flow

Some research suggests that cervical manipulation may influence vertebral artery blood flow, though the clinical significance for headaches remains uncertain (Mitchell, 2009).

Autonomic Nervous System Effects

Studies have found that manual therapy may influence autonomic nervous system balance, which could theoretically affect headache patterns, particularly in migraines (Tuchin et al., 2000).

Important Note: These are proposed mechanisms based on research, not proven causal pathways. The exact mechanisms through which manual therapy affects headaches are not fully understood and likely vary between individuals and headache types.

Medication Use and Overuse Headaches

Many Australians rely heavily on pain medications for headache management. However, medication-overuse headache (MOH) is a significant concern.

Research published in The Journal of Headache and Pain indicates that regular use of pain medications (more than 10-15 days per month) can actually cause rebound headaches and worsen the underlying headache condition (Evers & Marziniak, 2010).

A study in Cephalalgia found that approximately 1-2% of the general population suffers from medication-overuse headaches, with prevalence as high as 30-50% among patients attending headache clinics (Kristoffersen et al., 2012).

Potential Benefits of Non-Pharmaceutical Approaches:

Reducing reliance on pain medications may help prevent medication-overuse headaches
Manual therapy approaches have minimal side effects when performed by qualified practitioners
Non-pharmaceutical options may be suitable for people who cannot tolerate medications
Complementary approaches may be used alongside medical management when appropriate

Important Clarification: This is not suggesting people should stop taking prescribed medications. Any changes to medication should be discussed with the prescribing doctor.

What to Expect: Assessment and Care

Comprehensive Headache Assessment

A thorough chiropractic evaluation for headaches should include:

Detailed headache history (frequency, duration, intensity, location, triggers)
Red flag screening to identify serious underlying conditions
Cervical spine examination including range of motion and palpation
Neurological screening when appropriate
Postural and ergonomic assessment
Identification of contributing factors (stress, sleep, diet, etc.)

Red Flags Requiring Immediate Medical Attention:

Sudden, severe headache (“thunderclap” headache)
Headache with fever, stiff neck, confusion, or altered consciousness
Headache following head trauma
Progressive headache that worsens over time
New headache in people over 50 or with cancer history
Headache with neurological symptoms (weakness, vision changes, speech difficulties)
Change in established headache pattern

If any red flags are present, immediate medical evaluation is essential. Chiropractors are trained to recognize these warning signs and refer appropriately.

Potential Treatment Approaches

Based on assessment findings, chiropractors may utilize:

Spinal manipulation or mobilization of the cervical and thoracic spine
Soft tissue therapy for neck and shoulder muscles
Trigger point therapy for muscular tension
Postural advice and ergonomic modifications
Stretching and strengthening exercises
Lifestyle counseling regarding headache triggers
Stress management strategies

Evidence-Based Treatment Planning

Responsible care involves:

Setting realistic goals (e.g., reducing headache frequency or intensity, not promising complete elimination)
Defining a trial period (typically 6-12 treatments) to assess response
Regular reassessment of progress
Modification or discontinuation of care if no improvement occurs
Collaboration with medical practitioners when appropriate

Collaborative Care Approach

Headache management often benefits from a multidisciplinary approach. Chiropractors in Australia frequently work alongside:

General practitioners for overall medical management
Neurologists for complex or severe headache cases
Physiotherapists for additional rehabilitation
Psychologists for stress and behavioral factors
Dietitians for dietary trigger identification
Pain specialists when appropriate

This collaborative approach ensures comprehensive care addressing all contributing factors.

What the Evidence Tells Us About Treatment Duration

Research on treatment duration for headache management shows variable results:

A study in Journal of Manipulative and Physiological Therapeutics found that most patients who respond to chiropractic care for cervicogenic headaches show improvement within 6-8 treatments, with diminishing returns after 12 sessions (Haas et al., 2004).

Clinical practice guidelines suggest that if no improvement is observed after a reasonable trial period (typically 8-12 treatments over 4-6 weeks), alternative approaches should be considered (Bryans et al., 2011).

Realistic Expectations:

Not everyone responds to chiropractic care for headaches
Improvement is often gradual rather than immediate
Complete elimination of headaches is not guaranteed
Some people may require ongoing maintenance care, while others achieve sustained improvement with limited treatment
Individual responses vary considerably

Self-Management and Prevention Strategies

Evidence supports several self-management approaches for headaches:

Lifestyle Modifications

Research published in Headache journal demonstrates that certain lifestyle factors significantly impact headache patterns:

Regular sleep schedules and adequate sleep quality
Stress management and relaxation techniques
Regular physical activity and exercise
Hydration and balanced nutrition
Limiting alcohol and caffeine intake (O’Brien et al., 2010)

Ergonomic Considerations

For people with work-related headaches, research supports:

Proper workstation setup to reduce neck strain
Regular breaks from sustained postures
Computer screen positioning to minimize neck flexion
Managing stress and workload when possible

Trigger Identification

Keeping a headache diary can help identify:

Dietary triggers
Sleep pattern correlations
Stress factors
Hormonal influences
Environmental factors (lights, sounds, smells)

Limitations and Honest Expectations

In accordance with evidence-based practice and AHPRA requirements, it’s essential to acknowledge:

What We Know:

Some people with cervicogenic headaches benefit from chiropractic care
Manual therapy may provide similar benefits to first-line medications for some headache types
Chiropractic care appears to have a favorable safety profile when performed by qualified practitioners
Multidisciplinary approaches often work better than single interventions

What We Don’t Know:

Why some people respond to treatment while others don’t
The optimal treatment frequency and duration for different individuals
Long-term outcomes beyond 6-12 months for most headache types
How to predict who will benefit before starting treatment

What We Cannot Claim:

That chiropractic cures headaches or migraines
That everyone will respond to treatment
That results are permanent without ongoing management
That chiropractic can replace medical care for all headache types
That serious underlying conditions can be treated with manual therapy alone

Making Informed Decisions About Headache Care

If you’re considering chiropractic care for headaches:

Consult your GP first if you have new, severe, or changing headache patterns
Seek proper diagnosis – different headache types require different approaches
Rule out serious causes through appropriate medical evaluation
Set realistic goals focused on reducing frequency and intensity rather than complete cure
Give treatment a fair trial (typically 6-12 sessions) before judging effectiveness
Monitor your progress objectively with a headache diary
Be open to multimodal care – combining approaches often works best
Don’t abandon medical management without discussing with your doctor

Questions to Ask Your Chiropractor

When discussing headache care, consider asking:

What type of headache do you think I have, and what’s the evidence for treating it?
What’s a realistic expectation for improvement in my case?
How many treatments will we try before reassessing?
What are the risks and potential side effects?
When would you refer me back to my GP or to a specialist?
What can I do between treatments to help manage symptoms?
How will we measure progress objectively?

Our Evidence-Based Approach to Headache Management

At Bateman Chiropractic, we provide thorough, honest assessment and care for headache sufferers:

We Commit To:

Comprehensive evaluation including red flag screening
Evidence-based treatment recommendations
Clear communication about realistic expectations
Defined treatment trials with regular progress monitoring
Referral to appropriate specialists when needed
Collaborative care with your other healthcare providers
Transparent discussion about what we can and cannot help with

We Don’t:

Claim to cure all headaches
Ignore the need for medical evaluation
Continue treatment indefinitely without demonstrable benefit
Make exaggerated promises about outcomes
Discourage appropriate medical management
Use scare tactics about medications

When to Seek Our Care

Chiropractic assessment may be appropriate if you experience:

Headaches with associated neck pain or stiffness
Headaches triggered by neck movements or sustained postures
Frequent tension-type headaches
Headaches related to poor posture or workplace ergonomics
Desire to reduce reliance on pain medications
Interest in complementary approaches alongside medical care

Book a Consultation

If you’d like to discuss whether chiropractic care might be appropriate for your headaches, we invite you to schedule an initial consultation. During this visit, we’ll:

Conduct a thorough headache and health history
Perform appropriate physical examination
Screen for conditions requiring medical referral
Provide honest assessment of whether we can help
Discuss evidence-based treatment options
Answer all your questions
Refer you to appropriate specialists if needed

Contact 9310 5229 or book online for an assessment.

This information is for educational purposes and does not replace professional medical advice. Anyone experiencing severe, sudden, or unusual headaches should seek immediate medical evaluation.

References

Australian Institute of Health and Welfare. (2022). Chronic conditions and multimorbidity. AIHW, Australian Government.

Bialosky, J. E., et al. (2009). Spinal manipulative therapy-specific changes in pain sensitivity in individuals with low back pain. Journal of Pain, 10(4), 447-485. https://doi.org/10.1016/j.jpain.2008.10.005

Biondi, D. M. (2005). Cervicogenic headache: A review of diagnostic and treatment strategies. Journal of the American Osteopathic Association, 105(4 Suppl), 16S-22S.

Bogduk, N., & Govind, J. (2009). Cervicogenic headache: An assessment of the evidence on clinical diagnosis, invasive tests, and treatment. The Lancet Neurology, 8(10), 959-968. https://doi.org/10.1016/S1474-4422(09)70209-1

Bronfort, G., et al. (2004). Efficacy of spinal manipulation for chronic headache: A systematic review. Journal of Manipulative and Physiological Therapeutics, 27(7), 457-465. https://doi.org/10.1016/j.jmpt.2004.07.001

Bryans, R., et al. (2011). Evidence-based guidelines for the chiropractic treatment of adults with headache. Journal of Manipulative and Physiological Therapeutics, 34(5), 274-289. https://doi.org/10.1016/j.jmpt.2011.04.008

Castien, R. F., et al. (2011). Manual therapy and exercise for the management of tension-type headache. European Journal of Neurology, 18(3), 404-411. https://doi.org/10.1111/j.1468-1331.2010.03199.x

Chaibi, A., & Russell, M. B. (2014). Manual therapies for primary chronic headaches: A systematic review of randomized controlled trials. The Journal of Headache and Pain, 15, 67. https://doi.org/10.1186/1129-2377-15-67

Chaibi, A., et al. (2017). Spinal manipulative therapy for acute low back pain. European Journal of Neurology, 24(1), 143-154. https://doi.org/10.1111/ene.13166

Evers, S., & Marziniak, M. (2010). Clinical features, pathophysiology, and treatment of medication-overuse headache. The Lancet Neurology, 9(4), 391-401. https://doi.org/10.1016/S1474-4422(10)70008-9

GBD 2016 Headache Collaborators. (2018). Global, regional, and national burden of migraine and tension-type headache, 1990–2016. The Lancet Neurology, 17(11), 954-976. https://doi.org/10.1016/S1474-4422(18)30322-3

Haas, M., et al. (2004). Dose-response for chiropractic care of chronic cervicogenic headache. Journal of Manipulative and Physiological Therapeutics, 27(9), 547-553. https://doi.org/10.1016/j.jmpt.2004.10.007

Haas, M., et al. (2010). Chronic headache intervention trial: A randomized trial for drug versus spinal manipulation. The Spine Journal, 10(2), 117-128. https://doi.org/10.1016/j.spinee.2009.09.002

Kristoffersen, E. S., et al. (2012). Medication-overuse headache: Epidemiology, diagnosis and treatment. Therapeutic Advances in Drug Safety, 3(2), 87-99. https://doi.org/10.1177/2042098611433933

Migraine & Headache Australia. (2018). The cost of headache and migraine in Australia. Migraine & Headache Australia.

Mitchell, J. (2009). Vertebral artery blood flow velocity changes associated with cervical spine rotation. Journal of Manipulative and Physiological Therapeutics, 32(9), 685-691. https://doi.org/10.1016/j.jmpt.2009.10.005

O’Brien, H. L., et al. (2010). Behavioral management of headache in primary care. Headache, 50(10), 1546-1555. https://doi.org/10.1111/j.1526-4610.2010.01792.x

Racicki, S., et al. (2013). Conservative physical therapy management for the treatment of cervicogenic headache: A systematic review. Manual Therapy, 18(2), 113-117. https://doi.org/10.1016/j.math.2012.08.008

Stovner, L. J., et al. (2007). The global burden of headache: A documentation of headache prevalence and disability worldwide. Cephalalgia, 27(3), 193-210. https://doi.org/10.1111/j.1468-2982.2007.01288.x

Tuchin, P. J., et al. (2000). A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics, 23(2), 91-95. https://doi.org/10.1016/s0161-4754(00)90073-3

Vernon, H., et al. (2009). Systematic review of the risk factors for cervical artery dissection. Journal of Manipulative and Physiological Therapeutics, 32(5), 386-395. https://doi.org/10.1016/j.jmpt.2009.04.004