Should You See a Chiropractor for Migraine?
As a long-time chronic migraineur, I’ve been the recipient of numerous “have you tried X?” suggestions. Topping the list of recent suggestions given by well-meaning friends, family, and strangers is chiropractic care. Though considered an alternative therapy, spinal manipulation does have side effects and it isn't for everyone. So I decided to do some research.
In one randomized, controlled trial,1 83 volunteer migraineurs were treated with chiropractic spinal manipulative therapy. Participants kept a standard migraine diary for the length of the study, which lasted for six months. Researchers established a baseline for each participant during the first two months. Treatment occurred during months three and four.
At the end of the six-month period, researchers used the diaries to compare the participants’ migraine frequency, intensity, duration, disability, symptoms, and medication usage before and after the chiropractic treatment. These results were then compared to a control group of 40 individuals who kept the same diary for the same length of time but didn’t undergo treatment.
According to the study, 22% of the participants who underwent treatment reported a 90% reduction in migraine frequency. Another 49% reported a reduction in migraine intensity. Participants treated with chiropractic spinal manipulation also experienced significant improvement in disability associated with their attacks and a significant reduction in medication usage when compared to the control group.
Why this happened, though, remains unclear. According to the study’s authors, it may simply be that the chiropractic treatment served as an effective stress reliever:
“The results of this study support previous results2 showing that some people report significant improvement in migraines after chiropractic SMT [spinal manipulative therapy]. [However,] a high percentage (>80%) of participants reported stress as a major factor for their migraines. It appears probable that chiropractic care has an effect on the physical conditions related to stress and that in these people the effects of the migraine are reduced.”
If the improvements experienced by the participants in the study were a result of decreased stress and not the spinal manipulations themselves, then it seems probable that any therapy or activity that serves as a potent stress reliever would be as effective in treating migraine as chiropractic care. (This could also be behind the effectiveness of yoga and essential oils experienced by some migraineurs.) If, however, the physical manipulations are somehow changing the body’s response to stress, then we could expect chiropractic care to work better than other stress-reducing therapies.
Unfortunately, there isn’t a lot of research in this area yet, and none that I could find that compares chiropractic care to other alternative therapies in the treatment of migraine. One comparison study does exist, but it compares chiropractic care to a drug: amitriptyline. In that study,3 spinal manipulation appeared nearly as effective in reducing migraine frequency and intensity as amitriptyline (40% reduction compared to 49%), though combining the treatments didn’t add any extra benefits.
Based on these studies, it seems chiropractic care may be worth a try if you don’t have any contraindications to treatment (e.g., osteoporosis, nerve damage, numbness, tingling, and/or loss of strength in an arm or leg). It is worth noting, however, that the studies done so far have been very small, and more research needs to be done to know if and why spinal manipulations help migraine. Anecdotal evidence also seems to suggest that migraineurs who experience consistent and/or frequent neck pain may have better luck with chiropractic care than others.
How much has your migraine disease changed or evolved over time?