Quick answer: A chiropractor may help some headaches, but the evidence depends on the type. Research is strongest for headaches that start in the neck (cervicogenic headaches). For migraines, studies show a small benefit that may be partly placebo. For common tension headaches, spinal manipulation is not well supported. See a doctor first for new, severe or changing headaches, and tell any chiropractor about your full health history.
Many people search for a chiropractor when headaches keep coming back. This guide explains what research says about chiropractic care for each headache type, what a visit usually looks like, the risks of neck adjustments, warning signs that need a doctor instead, and questions to ask before you book. It is general information, not medical advice.
In this guide
Does a chiropractor help? It depends on the headache
“Headache” covers several conditions. The research on chiropractic care is different for each one. The table below summarizes a 2011 chiropractic practice guideline published in the Journal of Manipulative and Physiological Therapeutics (Bryans et al.), plus later studies.
| Headache type | What it is | What the evidence says about chiropractic care |
|---|---|---|
| Cervicogenic headache | Head pain that comes from the neck | Spinal manipulation, joint mobilization and deep neck flexor exercises rated as options, with moderate evidence (2011 guideline) |
| Migraine | Recurring attacks, often throbbing, with nausea or light sensitivity | Rated as an option with moderate evidence in 2011. A 2019 review found a small benefit. A 2017 trial suggests much of it may be placebo. |
| Tension-type headache (episodic) | Band-like pressure, the most common headache | Spinal manipulation not recommended (2011 guideline). Gentle low-load neck mobilization was recommended. |
| Tension-type headache (chronic) | Tension headaches on 15 or more days a month | Not enough evidence to recommend for or against spinal manipulation (2011 guideline) |
What the research says
The 2011 chiropractic guideline
A team of chiropractic researchers reviewed the studies and rated each treatment. For migraine, they rated spinal manipulation as an option with moderate evidence, based on studies that used 1 to 2 treatments a week for 8 weeks. They also rated weekly massage and multimodal care (exercise, relaxation, stress and nutrition counseling, and massage) as options for migraine. For cervicogenic headache, they rated spinal manipulation, joint mobilization and neck exercises as options. For episodic tension-type headache, they said spinal manipulation cannot be recommended.
The 2019 migraine review
A 2019 review in the journal Headache (Rist and colleagues) pooled six randomized trials with 677 people. Spinal manipulation reduced migraine days, but the effect was small, and the authors called the results preliminary. Source: summary in MDedge.
The 2017 placebo-controlled trial
A Norwegian trial published in the European Journal of Neurology (Chaibi and colleagues) compared real chiropractic manipulation, a fake (sham) procedure, and usual medication care. Migraine days dropped in both the real and fake groups. The authors concluded the effect was probably a placebo response. They said it could still be considered when other treatments don’t work or cause side effects. Side effects were mild and short-lived but more common with real manipulation. Source: National Headache Foundation.
The federal view
The National Center for Complementary and Integrative Health (NCCIH), part of the NIH, says spinal manipulation is often used for headaches, but it is uncertain whether it helps because studies have had contradictory results. Source: NCCIH, Headaches: What You Need To Know.
What to expect at a visit
Step 1: History and exam
Expect questions about how often the headaches happen, what they feel like, triggers, medicines and past injuries. The chiropractor should check your neck movement, posture and nerves.
Step 2: Screening for warning signs
A careful chiropractor looks for signs that need a medical workup first and refers you if any show up. See the warning signs below.
Step 3: Treatment
Care may include spinal manipulation (an adjustment), gentler mobilization, soft tissue work, and neck or posture exercises. You can ask for gentler options instead of a fast neck adjustment.
Step 4: A plan with a check-in date
Ask how many visits are planned and when you will judge whether it is working. Track your headache days in a diary or app so you can compare.
Safety and neck adjustments
NCCIH says side effects of spinal manipulation can include temporary headaches, tiredness, or discomfort in the treated area. It also notes rare reports of strokes after upper neck manipulation, and that whether the manipulation caused them is unclear.
In 2014 the American Heart Association said neck manipulation may be associated with a rare type of stroke called cervical artery dissection (a tear in a neck artery). It said a cause-and-effect link has not been proven, and that providers should tell patients about the association before neck manipulation. Source: University of Nebraska Medical Center summary of the AHA statement.
When to see a doctor instead
Some headaches are a sign of something serious. Mayo Clinic says to get emergency care for a headache that:
- Is sudden and severe, or the worst headache you have ever had
- Comes with fever, or with nausea or vomiting not explained by another illness
- Comes with a stiff neck, rash, confusion, seizures, double vision, weakness, numbness or trouble speaking
- Follows a head injury, fall or bump
Mayo Clinic also advises a prompt doctor visit for a headache that keeps getting worse despite rest and over-the-counter pain medicine. A chiropractor is not the right first stop for any of these.
Also note that Texas chiropractors cannot prescribe medicine. Texas Occupations Code Chapter 201 says chiropractic does not include prescribing drugs that need a prescription, or surgery. If you need migraine medicine, you need a medical provider too.
How to choose a chiropractor for headaches
- Check the license. Every Texas chiropractor must be licensed by the Texas Board of Chiropractic Examiners. Our guide shows how to check a chiropractor’s license in Texas and look for board discipline.
- Ask about headache experience. Ask how often they treat headaches and which types.
- Ask what techniques they use. Ask whether they offer gentle mobilization and exercises, not only fast neck adjustments.
- Ask about the plan. How many visits, what it costs, and how you will measure progress.
- Ask if they work with your doctor. A good chiropractor will send you to a doctor when a headache needs a medical workup.
Looking for a chiropractor in West Texas? Send a free request and we pass it to a participating local chiropractor. Free, no obligation.
Cost and insurance
Prices vary by clinic, so ask for the cost of the first visit and each follow-up before you book. Coverage depends on your plan:
- Medicare: Part B covers only spinal adjustments to correct a subluxation. After the Part B deductible you pay 20% of the Medicare-approved amount. Medicare does not cover other services a chiropractor orders, such as X-rays, massage or acupuncture. Source: Medicare.gov.
- Private insurance: Many plans cover some chiropractic visits, often with a visit limit or a referral rule. Call the number on your card and ask.
- Cash price: Some clinics offer a set cash rate or visit packages. Ask what happens to unused visits before you prepay.
Frequently asked questions
Can a chiropractor help with migraines?
Maybe. A 2011 chiropractic guideline rated spinal manipulation as a moderate-evidence option for migraine, and a 2019 review of six trials found a small drop in migraine days. But a 2017 trial with a fake treatment group found real and fake manipulation worked about the same, so the benefit may be partly placebo. Talk with your doctor about the best plan for you.
Can a chiropractor help with tension headaches?
The evidence is weak. The 2011 chiropractic guideline said spinal manipulation cannot be recommended for episodic tension-type headache and made no call for chronic tension-type headache. It did recommend gentle low-load neck mobilization.
What is a cervicogenic headache?
It is head pain that comes from a problem in the neck. The 2011 chiropractic guideline rated spinal manipulation, joint mobilization and deep neck flexor exercises as moderate-evidence options for it.
Is neck adjustment safe for headaches?
Serious problems are rare. Common side effects include temporary soreness, tiredness or a headache. The American Heart Association says neck manipulation may be linked to a rare type of stroke, but a cause has not been proven, and providers should tell patients about it first.
How many chiropractic visits does it take for headaches?
There is no set number. The migraine studies in the 2011 guideline used 1 to 2 visits a week for 8 weeks. Ask the chiropractor for a plan with a set number of visits and a date to check whether it is working.
Does insurance cover a chiropractor for headaches?
It depends on your plan. Medicare Part B covers only spinal adjustments to correct a subluxation, and you pay 20% after the deductible. Medicare does not cover X-rays or massage that a chiropractor orders. Call your insurer to ask about private plans.
Can a chiropractor prescribe migraine medicine in Texas?
No. Texas law says chiropractic does not include prescribing drugs that need a prescription. For migraine medicine, see a medical doctor, nurse practitioner or physician assistant.
Find a chiropractor in your city
We have local pages for Abilene, Midland, Odessa, San Angelo, Lubbock, Amarillo, Wichita Falls, Waco and Tyler.
This guide is general information, not medical advice. Research findings can change. Talk with your doctor about headaches that are new, severe or getting worse.