Does Chiropractic Help Headaches?

This question gets answered badly in both directions. One side says chiropractic fixes headaches. The other says it does nothing. Neither is honest, because "headache" is not one condition. Whether hands-on care is reasonable to try depends almost entirely on which kind of headache you have. Here is how it splits, including the parts that do not favor us.

Headaches that come from the neck

The strongest case for manual care is a headache whose source is the neck itself. These are called cervicogenic headaches. The joints at the top of the neck, the muscles at the base of the skull, and the nerves running between them share pain pathways with the head, so trouble in those structures can be felt as head pain rather than neck pain.

That is why this type is different from the others. If the source really is a mechanical problem in the neck, treatment aimed at the neck is aimed at the cause and not at a symptom. This is the headache type where manual therapy makes the most sense on the anatomy alone, and where the support behind hands-on care is most reasonable. It tends to start at the base of the skull and spread forward toward an eye or a temple, stay on one side, worsen after long stretches of looking down, and come with a neck that is stiff or tender. Certain neck movements or held positions often bring it on.

Tension-type headache

Tension-type headache is the band-around-the-head kind, usually on both sides, commonly with sore, tight muscles through the neck and upper shoulders. The link to the neck is real but less direct than in a cervicogenic headache, and the picture from research here is mixed rather than settled. What can be said fairly is that manual therapy, soft tissue work, and exercise are reasonable options to try for this type, particularly when muscle tension and posture are clearly part of the pattern. Reasonable to try is not the same as proven to work for you, and anyone who tells you otherwise is selling something.

Migraine: the careful part

Migraine is a neurological condition. It is not a mechanical problem in the neck, and chiropractic is not a treatment for migraine. We will not present it as one.

What is true is narrower, and still worth knowing. Plenty of people who have migraine also have neck pain, stiffness, or muscle tension in the upper back, sometimes as part of an attack and sometimes as a separate problem sitting alongside it. Neck tension is a recognized trigger for some people. If you carry a migraine diagnosis and an exam finds a neck that is restricted, tender, and reproducing some of your pain on movement, that neck problem can be addressed on its own terms. What is being treated in that case is your neck. The migraine belongs with your physician or your neurologist, and you should keep that relationship whatever else you do.

What an exam actually looks at

The useful question is not whether chiropractic helps headaches in general. It is whether yours has a neck component. That is what the first visit is for.

• Neck range of motion, and which directions are limited or painful
• Restriction at individual joints in the upper neck, checked by hand rather than assumed
• Muscle tension patterns at the base of the skull, through the neck, and across the upper back
• Whether neck movement or a sustained position reproduces your headache, which is one of the more telling findings
• Head carriage and posture, plus the setup you spend hours in: a desk, a phone, a helm, a nav station, overhead work
• Your history and the pattern of the headaches themselves

Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands. He examines new patients himself, and if the findings do not point to the neck, he will say so and refer you. What the care involves when the neck is the source is on our headaches and migraines page. If your concern is the safety of neck adjustment, that is covered on is chiropractic safe.

When the answer is a doctor, not a chiropractor

Some headaches are not a question of which treatment to try. Call 911 or go to the nearest emergency room for:

• A sudden severe headache unlike any you have had before, one that hits full force in seconds
• A headache with fever and a stiff neck
• A headache with weakness, slurred speech, facial droop, or vision loss
• A headache after a head injury, a fall, or a crash
• A new headache pattern in someone over 50

Those are urgent medical situations. Is my headache serious has the fuller list and what each sign points to.

Getting seen

Call (340) 690-4994 and describe the headache, including where it starts and what makes it worse. We take walk-ins and same-day appointments. We are at the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802, just east of Charlotte Amalie and a short drive from the Havensight cruise port and Yacht Haven Grande. Hours are Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun. New patient forms are at forms. Tradewinds Chiropractic has more than 180 five-star Google reviews.

Questions patients ask

Does chiropractic help headaches?

It depends on the type. For a headache coming from the neck, called a cervicogenic headache, care aimed at the neck is aimed at the actual source, and that is the type most reasonably treated with hands-on care. For tension-type headache it is a reasonable option, with a less certain picture behind it. For migraine, chiropractic is not a treatment for the condition itself. An exam is what tells you which situation you are in.

Can a chiropractor help migraines?

Not with the migraine itself. Migraine is a neurological condition and belongs with your physician or neurologist, and you should keep that relationship. Some people with migraine also have a neck problem or neck tension sitting alongside it, and that neck problem can be examined and treated on its own terms. That is a different claim from treating migraine, and we keep the two separate.

Does chiropractic work for tension headaches?

It is a reasonable thing to try, particularly when muscle tension through the neck and upper back and long hours in one posture are clearly part of your pattern. Manual therapy, soft tissue work, and exercise are all sensible options for this type. The honest framing is that it is worth assessing rather than guaranteed to help.

How would a chiropractor tell whether my headache is worth treating?

By examining the neck rather than going on the description alone. Range of motion, restriction at individual joints in the upper neck, muscle tension patterns, posture and head carriage, and whether neck movement reproduces your headache. If neck movement brings your headache on, that is one of the more useful findings. If none of it points to the neck, that answer is worth having too.

What if chiropractic does not help my headaches?

Then it was the wrong treatment for your headache type, and that is a real possibility worth planning for. Care here comes with a re-check rather than an open-ended plan, so if the headaches are not responding, the options are to change course or to refer you to a physician or a neurologist. Dr. Keys will tell you which.