Clarksville TN Chiropractors May Relieve Migraines
During a migraine attack very little else registers. It can mean an afternoon in a dark room, work abandoned and plans cancelled. Before anything about treatment, the features below are the ones that need assessment rather than management.
Read this part first: the features that need urgent assessment
Seek emergency medical care for:
- 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.
Arrange prompt medical review for:
- 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
This list is not exhaustive, the timings on it are approximate, and it is not a test to pass before seeking help. If something about your headache worries you, that is reason enough.
What migraine is
Migraine is common. It is not a severe tension headache and it is not simply a bad headache; it is a distinct neurological condition. An untreated attack lasts somewhere between four hours and three days. The formal definition asks for at least two of four features rather than all of them: pain on one side, a pulsating quality, moderate or severe intensity, and being made worse by ordinary physical activity such as walking or climbing stairs, or causing you to avoid it. An attack also involves at least one of nausea or vomiting, or the combination of light and sound sensitivity.
Some people experience an aura: fully reversible symptoms that can be visual, sensory, or affect speech and language. As with the attack itself, the definition is a threshold rather than a portrait, and ICHD-3 asks for at least three of six characteristics, among them gradual spread over five minutes or more, a duration of five to sixty minutes per symptom, and headache following within the hour. Not everyone with migraine has aura, and aura can occur without a headache following it.
Why this page does not give you a checklist
An earlier version of this page set out numbered criteria and told readers how many symptoms they needed in order to count as a migraine sufferer. That has been removed deliberately.
Those thresholds are real, and they come from the International Classification of Headache Disorders, but they are diagnostic criteria written for clinicians applying them to a person in front of them, alongside an examination and a history. Handed to a reader in isolation they do two kinds of harm. Someone whose pattern falls a symptom short concludes they do not have migraine and does not seek treatment that would help. Someone whose pattern fits concludes the question is settled and stops looking, when a secondary headache can imitate migraine closely. The classification itself warns that telling mild migraine from tension-type headache is the hardest discrimination in the field, and that people with frequent headaches often have both at once.
Describing your pattern accurately is genuinely useful. Scoring yourself against a rubric is not, and this page will not help you do it.
What a chiropractic examination can and cannot offer
An examination answers one question: whether the neck is contributing to your headache pattern. Neck pain is among the more commonly reported features around migraine attacks, and headache referred from the upper cervical joints, called cervicogenic headache, can coexist with migraine or be mistaken for it. Assessing the movement and tenderness of those joints, and whether the headache can be provoked or eased through the neck, is a specific and answerable question.
What it is not: an examination does not diagnose migraine, does not treat the neurological mechanism of a migraine attack, and is not a substitute for medical assessment of a headache disorder. Where the picture is migraine rather than a neck-related pattern, the honest answer 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.
Safety, alternatives, and what else treats this
A realistic assessment of the risk. Manual treatment of the neck is not risk-free. Short-lived soreness, headache or tiredness after treatment are the effects reported most often. Serious events, including injury to the arteries in the neck, are reported rarely, and whether manipulation causes them or coincides with an arterial problem already underway remains genuinely unsettled in the research. Rarely reported is not the same as rare: there is no systematic reporting system for adverse events after manual therapy, so the true rate is not known. Where an examination suggests an arterial cause, manual treatment of the neck is not appropriate and immediate referral is.
The alternatives, and what they are good for.
- Medical treatment of migraine carries the strongest evidence of anything on this list. It divides into treatments taken at the onset of an attack 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, not the last.
- Identifying and treating a secondary cause. Headache on most days in someone regularly taking pain relief can be caused by the pain relief itself, and that pattern will not respond to anything else until it is addressed.
- Trigger identification with a headache diary. Low cost, no risk, and the only reliable way to find patterns that are specific to you rather than to a general list.
- Physical therapy and graded exercise, where a neck component has actually been identified.
If you want the neck question answered
That is what an examination here is for, and it is worth having answered if your headaches come with neck pain or stiffness, or if position and movement seem to change them. Contact Source Chiropractic to arrange one. If your migraines are frequent, severe, or changing in pattern, arrange a medical assessment as well, and do not wait on this.
Related: headache tips and what an examination looks for, and the different types of headaches.
Follow the evidence
Research, with context.
Published sources behind the discussion. Read the findings alongside the limits; a study is not a diagnosis or a promise of a result.
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 cannot tell usThe trial was small. Secondary outcomes do not overturn the primary result, and a treatment trial of this size cannot establish the frequency of rare serious harms.
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 cannot tell usParticipants were not blinded, and the combined approach was not significantly superior. These findings concern 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
Read our editorial policy for how sources and clinical review are identified.