Clarksville TN Chiropractors May Relieve Migraines
During a migraine attack, very little else registers. It can mean an afternoon in a dark room, a missed day of work and canceled plans. Here's the short answer on chiropractors and migraines: what we can do as chiropractors in Clarksville is examine your neck and tell you what we find, including when your neck doesn't look like part of the problem. Migraine itself is a neurological condition, and of the options covered below, medical treatment has the strongest evidence. First, though, the headache signs that need a doctor, not us.
Read this first: migraine and headache signs that need urgent care
If you have any of these, get emergency medical care. Please don't wait for an appointment with us:
- A headache of sudden, severe onset, reaching maximum intensity within about five minutes
- Headache with fever, or with a stiff neck, or with a rash. Any one of these is enough, and they often do not appear together
- Headache with new neurological symptoms: weakness, numbness, difficulty speaking, confusion, loss of coordination, or visual loss
- Headache after a head injury, particularly with drowsiness or repeated vomiting
- A painful red eye with blurred vision or halos seen around lights
- In anyone over fifty, a new headache with scalp tenderness, pain in the jaw when chewing, or any change in vision. Visual loss from this cause can be permanent, and it is treatable if caught early.
- Severe neck pain, or a new and unexplained headache, or both, especially alongside visual disturbance, unsteadiness or slurred speech. Either symptom alone can be the first sign. That combination can indicate a tear in an artery in the neck, and it needs immediate medical investigation rather than manual treatment. It does not always announce itself at once: in reported cases the neurological signs followed the first headache or neck pain by a median of several hours to several days, so a day or two of "just" severe neck pain and headache does not rule it out.
These call for a prompt visit to your medical doctor:
- A headache that is new in a person over fifty
- A headache that has changed its usual pattern, or is progressively worsening
- A headache consistently worse on coughing, straining or exertion
- A headache that changes markedly with posture, clearly worse either standing up or lying down
- Headache with vomiting that has no other explanation
- Headache in someone who is pregnant or has recently given birth, is immunosuppressed, or has a history of cancer
- Headache on most days of the month in someone taking pain relief for it regularly, which can be caused by the pain relief itself
These lists don't cover everything, the timings on them are approximate, and you don't have to pass a test before you get help. If something about your headache worries you, that's reason enough.
What is a migraine?
Migraine is common. It isn't a severe tension headache, and it isn't just a bad headache: it's a distinct neurological condition. An untreated attack lasts anywhere from four hours to three days. The formal definition lists four classic features and needs any two of them: pain on one side, a pulsing quality, moderate or severe intensity, and pain that gets worse with ordinary activity like walking or climbing stairs, or that makes you avoid it. An attack also brings at least one of two things: nausea or vomiting, or sensitivity to both light and sound.
Some people have an aura: symptoms that go away completely, and that can be visual, sensory, or affect speech and language. Like the attack itself, aura has a formal definition with a minimum count: the International Classification of Headache Disorders (ICHD-3) asks for at least three of six characteristics, among them a gradual spread over five minutes or more, each symptom lasting five to sixty minutes, and a headache following within the hour. Not everyone with migraine has aura, and an aura can come without a headache after it.
Why we don't give you a migraine checklist
You won't find a symptom-count checklist for migraine here, and that's on purpose.
The thresholds are real. They come from ICHD-3, but they're diagnostic criteria, written for the person making a diagnosis and applied to a patient in front of them, along with an exam and a history. Handed to a reader with nothing else, they can do harm in two ways. If your pattern falls one symptom short, you might decide you don't have migraine and never look for treatment that would help. If it fits, you might decide the question's settled and stop looking, when a secondary headache can imitate migraine closely. The classification itself warns that telling mild migraine from tension-type headache is the hardest call in the field, and that people with frequent headaches often have both at once.
An accurate description of your pattern is genuinely useful to whoever examines you: when the headaches come, how long they last and what comes with them. That tells us far more than a count of criteria would.
What can a chiropractor do for migraines?
The question a neck exam can answer here is a narrow one: is your neck contributing to your headache pattern? Neck pain is among the more commonly reported features around migraine attacks, and headache referred from the upper joints of the neck, called cervicogenic headache, can show up alongside migraine or be mistaken for it. Answering that question means checking how those joints move and how tender they are, and seeing if the headache can be brought on or eased through the neck. Our headaches and migraines guide covers what the research shows on chiropractic care for migraine.
Here's where our part ends. Diagnosing migraine and treating the neurological mechanism of an attack are medical work, and our exam is no substitute for a doctor's assessment of a headache disorder. If what we find looks like migraine and not a neck-related pattern, the right next step is a referral. If we are not able to help with your problem, we will make sure to give you a recommendation to another experienced provider.
What are the risks, and what else is used for migraines?
A realistic look at the risk. Manual treatment of the neck isn't risk-free. The effects reported most often are short-lived soreness, headache or tiredness afterward. Serious events, including injury to the arteries in the neck, are reported rarely, and researchers still don't know if manipulation causes them or just happens to coincide with an artery problem that was already underway. Rarely reported isn't the same as rare: there's no systematic reporting system for problems after manual therapy, so nobody knows the true rate. If an exam suggests an artery problem, manual treatment of the neck is off the table and immediate referral is what's needed.
The other options, and what they're good for.
- Medical treatment of migraine has the strongest evidence of anything on this list. It comes in two kinds: treatments taken when an attack starts, to stop it, and treatments taken regularly to reduce how often attacks happen. A chiropractor provides neither, and for frequent or disabling migraine this is the first conversation to have.
- Finding and treating a secondary cause. Headache on most days in someone who regularly takes pain relief can be caused by the pain relief itself, and that pattern won't respond to anything else until it's dealt with.
- A headache diary to spot triggers. It costs little, carries no risk, and it's the only reliable way to find the patterns that are specific to you and not to a general list.
- Physical therapy and graded exercise, where a neck component has actually been found.
Want to know if your neck is part of your migraines?
That's what an exam here is for, and it's worth having if your headaches come with neck pain or stiffness, or if position and movement seem to change them. Our headache tips and what an exam looks for and our guide to the different types of headaches go deeper. When you're ready, call our Clarksville office and we'll set up an exam; if you're new to us, that starts with our new patient visit. If your migraines are frequent, severe or changing in pattern, see your medical doctor about them too, and don't wait for an exam here to do it.
Follow the evidence
Research, with context.
Selected published sources behind what we've written, each with what it found and what it can't tell us. We give you both halves because no paper can diagnose you or predict how your own care will go.
Chiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial
104 people with migraine, assigned spinal manipulation, sham treatment or usual pharmacological management.
What it foundMigraine days decreased in all groups, with no significant between-group difference in the primary outcome. The authors considered the observed manipulation effect probably a placebo response.
What it can't tell usIt was a small trial. Its secondary outcomes don't overturn the main result, and a trial this size is too small to show how often rare serious harms happen.
Publication details & citation
Chaibi et al. Chiropractic spinal manipulative therapy for migraine: a three-armed, single-blinded, placebo, randomized controlled trial. European Journal of Neurology. 2017. DOI: 10.1111/ene.13166.
Read the publication recordA randomized controlled trial of exercise and manipulative therapy for cervicogenic headache
200 people with cervicogenic headache, assigned to manipulation, specific exercise, both, or a control group.
What it foundManipulative therapy and exercise each reduced headache frequency and intensity, with benefits reported at 12 months.
What it can't tell usParticipants weren't blinded, and the combined approach wasn't significantly superior. The findings are about headache that starts in the neck (cervicogenic headache), not migraine in general.
Publication details & citation
Jull et al. A randomized controlled trial of exercise and manipulative therapy for cervicogenic headache. Spine. 2002. DOI: 10.1097/00007632-200209010-00004.
Read the publication record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.