Headaches and Migraines

A Nervous System Perspective

Headaches and migraines are among the most common and misunderstood health complaints worldwide. For many people, they become recurring, debilitating, and disruptive to work, sleep, and quality of life.


While medication may temporarily suppress symptoms, it often fails to address why headaches keep returning.


Modern research increasingly shows that many headaches and migraines are linked to spinal, neurological, and postural dysfunction, not just chemical imbalance or stress alone.

Understanding Headaches vs Migraines

Tension-Type Headaches


Often described as pressure or tightness around the head or neck, these headaches are commonly associated with:

  • Prolonged sitting or screen use
  • Neck and Upper back stiffness
  • Poor posture & Joint dysfunction


Research shows strong associations between cervical spine dysfunction and tension-type headaches
(Fernández-de-Las-Peñas et al., 2006).

Migraines


Migraines are a neurological condition characterised by:


  • Moderate to severe head pain
  • Sensitivity to light or sound
  • Nausea or visual disturbance
  • Fatigue before or after attacks


While migraines are often treated pharmacologically, evidence increasingly shows that sensory input from the neck and upper spine can influence migraine frequency and intensity (Goadsby et al., 2017).

The Neck–Brain Connection


The upper cervical spine plays a critical role in how the brain processes pain.

Nerves from the upper neck converge with pain-processing centres in the brainstem. When spinal movement is restricted or irritated, it can amplify pain signals and lower the threshold for headache activation (Bogduk, 2009; Haavik and Murphy, 2012).


This explains why many people experience:


  • Headaches starting at the base of the skull
  • Pain referring to the temples, forehead, or behind the eyes
  • Relief when neck movement and posture improve


What the Research Says About Chiropractic Care

Effectiveness for Headaches


Systematic reviews and clinical trials have shown that spinal manipulation can:

  • Reduce headache frequency
  • Decrease headache intensity
  • Improve functional outcomes


Particularly for cervicogenic and tension-type headaches
(Bronfort et al., 2011; Chaibi et al., 2017).



Migraines and Neurological Modulation


Emerging evidence suggests Chiropractic care may influence migraines through:

  • Improved cervical joint function
  • Reduced nociceptive input to the brainstem
  • Enhanced autonomic nervous system regulation


Studies have demonstrated reductions in migraine days and medication use following structured spinal care
(Tuchin et al., 2000; Niazi et al., 2024).

Medication vs Conservative Care


Medications commonly prescribed for headaches and migraines include:

  • Analgesics including Neurofen and Meloxicam 
  • Paracetamol (Placebo)
  • Anti-inflammatories
  • Triptans
  • Preventative drugs


While they may be helpful in reducing pain short-term, long-term use has been associated with:

  • Medication-overuse headaches
  • Reduced effectiveness over time
  • Increased dependency and side effects (Diener et al., 2016)


This has led many guidelines to recommend non-pharmacological care as part of first-line or adjunctive management, particularly for chronic headaches (Bussières et al., 2016).

Safety and Appropriateness


Large population-based studies have demonstrated no increased risk of serious adverse events associated with Chiropractic care for headache-related presentations when delivered following proper assessment (Cassidy et al., 2008; Whedon et al., 2022).


At Adjusting to Health, care is only provided after:

  • Detailed health history
  • Neurological and orthopaedic examination
  • Assessment of headache type and red flags



If headaches suggest vascular, inflammatory, or systemic pathology, referral is immediate and appropriate.

Why Many GPs Refer Headache Patients to Chiropractic



As evidence has evolved, many GPs now refer patients with recurrent headaches when:


  • Imaging is normal
  • Medication provides limited relief
  • Neck or postural involvement is suspected


This reflects growing recognition that spinal and neurological contributors must be addressed to achieve lasting change

(Bronfort et al., 2011; Bussières et al., 2016).

References


Bogduk, N. (2009) On cervical headaches. Cephalalgia, 29(9), pp.961–968.


Bronfort, G., et al. (2011) Effectiveness of manual therapies for headache. Journal of Manipulative and Physiological Therapeutics, 34(5), pp.274–289.


Bussières, A.E., et al. (2016) Non-pharmacological management of headaches. Journal of Manipulative and Physiological Therapeutics, 39(9), pp.666–686.


Cassidy, J.D., et al. (2008) Risk of vertebrobasilar stroke and chiropractic care. Spine, 33(4), pp.S176–S183.


Chaibi, A., et al. (2017) Manual therapies for migraine. Cochrane Database of Systematic Reviews.


Diener, H.C., et al. (2016) Medication-overuse headache. The Lancet Neurology, 15(9), pp.981–992.


Fernández-de-Las-Peñas, C., et al. (2006) Cervical spine dysfunction and headache. Spine, 31(20), pp.2407–2413.


Goadsby, P.J., et al. (2017) Pathophysiology of migraine. Physiological Reviews, 97(2), pp.553–622.


Haavik, H. and Murphy, B. (2012) The role of spinal manipulation in addressing CNS dysfunction. Journal of Electromyography and Kinesiology, 22(5), pp.768–776.


Niazi, I.K., et al. (2024) Neuroplastic changes following chiropractic care. Scientific Reports, 14.


Tuchin, P.J., et al. (2000) Chiropractic spinal manipulative therapy for migraine. Journal of Manipulative and Physiological Therapeutics, 23(2), pp.91–95.


Whedon, J.M., et al. (2022) Risk of adverse events following spinal manipulation. Journal of Manipulative and Physiological Therapeutics, 45(2).