Headaches - You Don't Need to Suffer
Recurring headaches are easier to sort out when you can describe the pattern: when they hit, how they feel and what they stop you from doing. Here at Source Chiropractic, our headache and migraine guide covers the condition, and the head and jaw section links the related guides and research.
When is a headache an emergency?
Call 911 or get emergency care for a sudden, unusually severe headache, or a headache that comes with new weakness, difficulty speaking, confusion or loss of vision. A severe headache with a fever or a stiff neck, or a headache after a head injury, also needs urgent medical assessment. The National Institute of Neurological Disorders and Stroke flags these same warning patterns. Please don't wait for an appointment with us.
What should a headache diary include?
For recurring headaches without those signs, bring a short diary. A good entry has the date, how long it lasted, where it hurt and how bad it got, plus any nausea, sensitivity to light or sound, or visual changes, and whatever happened just before. Then the medicine: what you took, how often you take it, and if it helped. Diagnosing a headache starts with your history, and a diary can help a doctor spot the pattern and see if a treatment is helping.
It also helps to note what each one cost you: did it make you leave work, skip a meal or stop what you were doing? Bring earlier diagnoses or test results too. Keeping a diary is no reason to wait, though: get a new or changing headache checked now, not after the diary fills up.
Does the type of headache change the treatment?
Yes. Migraine, tension-type headache and headache from a neck problem are different problems, and treatment follows the diagnosis. Migraine care can include medicine for an attack and preventive treatment to cut down future attacks, and taking that medicine isn't simply covering up some untreated cause. If you're taking pain medicine often, your prescriber should know, because overusing it can itself contribute to headaches.
We offer hands-on care, and what the research says about manual treatment depends on the headache type. The NCCIH review of headache research reports possible benefit from manual treatment for some cervicogenic headaches (the kind that start in the neck), with limitations in the research, and the evidence for preventing migraine isn't conclusive. Manual treatment isn't a cure, and none of this is a reason to stop a treatment you've been prescribed.
What are the risks of neck manipulation?
Temporary discomfort or a headache afterward can happen. Neck manipulation has also been associated with tears in the neck arteries that can cause a stroke, though whether manipulation causes them is debated, and how often it happens isn't accurately known. The medical treatments above, including preventive treatment to reduce future migraine attacks, are other options, and which fits depends on your headache type.
Questions to bring to a headache appointment
- Which headache diagnosis best fits my history, and what else needs to be ruled out?
- What are the options for an attack, and for prevention?
- How will I know a treatment is helping my daily life?
- What changes should send me back for a medical recheck?
If your headaches keep coming back, give our office a call and bring your diary. We'll read through the diary with you and check how your neck moves and where the muscles are tight, and if the pattern points outside muscles and joints, we'll say so and refer you. New patients can start at our new-patient page.
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.
A 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 recordChiropractic 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 record
Our editorial policy explains how to read these sources and what our clinical-review labels mean.