Complementary and alternative medicine (CAM) is a term used to describe non-mainstream healthcare approaches—which includes chiropractic care—that are used in conjunction with or in place of conventional medicine. Because the usual treatment approach for headaches often involves medications like nonsteroidal anti-inflammatory drugs (NSAIDS) and acetaminophen—which can cause side effects can affect the stomach, liver, and/or kidneys with prolonged use—nearly 50% of adults with headaches have used some form of CAM.
In a 2021 literature review, two researchers from McMaster University in Ontario reviewed clinical practice guidelines for either migraine or tension-type headaches and found recommendations for dietary supplements, oxygen therapy, herbal medicine, electrotherapy, acupuncture, behavioral therapy, manual therapy (chiropractic), homeopathy, and Chinese medicine referenced in the guidelines. Despite the fact that many of these approaches are supported by promising research, the researchers noted that only about 25% of American medical students, residents, and clinicians receive CAM training, and hence, often do not mention CAM options to their headache patients.
For patients whose headaches originate from dysfunction in the cervical spine (a cervicogenic headache) the data show that chiropractic care can be an effective treatment option. In one study, patients received either no treatment, sham treatment, or cervical spinal manipulation for 17 months. The results showed that the patients who received manipulative therapy experienced better outcomes with respect to headache frequency, pain, and disability, and any negative side effects were few, mild, and transient. The authors concluded that spinal manipulative therapy is a safe treatment option for patients with cervicogenic headaches.
Interestingly, several studies have also found that patients with migraines and other forms of headache often exhibit musculoskeletal abnormalities in the neck, such as trigger points in the cervical muscles, that when addressed lead to a reduction in headache severity and frequency. This suggests a few possibilities: cervical dysfunction may play a role in the headache process for non-cervicogenic headaches, patients with cervicogenic headaches may not have received a correct diagnosis, or cervicogenic headaches may often co-occur with other types of headaches.
When a patient initially consults with a chiropractor to manage their headaches, they’ll undergo a thorough examination of the head, neck, and even the shoulders, mid back, and low back to identify any potential contributing causes. Then, their doctor of chiropractic will employ a multimodal treatment approach to address these issues that may include spinal manipulation, soft tissue therapies, physical therapy modalities, specific exercises, nutritional counseling, and more. If necessary, they will co-manage the patient with allied healthcare providers.