Once a doctor of chiropractic has classified a headache, research indicates that patients should be educated about their diagnosis and involved with formation of their treatment plan.

A comprehensive treatment plan for headaches should be evidence-based and individualized, addressing the triggers of a patient's headaches. The American Academy of Family Physicians recommends incorporating pharmacologic and non-pharmacologic strategies, requiring a multi-
disciplinary approach between doctors of chiropractic and primary care physicians when appropriate. Such management includes recognizing the need to consider additional care for common comorbid conditions such as depression, anxiety, substance abuse and chronic musculoskeletal pain syndromes. (1)

Evidence-based treatment approaches in the chiropractic toolbox for both cervicogenic and tension-type headaches include spinal manipulation  and exercise (2, 3). Spinal manipulation may be more helpful in decreasing headache frequency and intensity in the short run (3), while endurance training of associated cervical musculature has shown to have a significant positive longer-term effect (2).

It is important to remember that the appropriate treatment of headaches is both a science and an art, relying on both an accurate diagnosis and effective treatment strategies. Clinical acumen, consideration of patient preferences and current research findings should all be used to guide the
development of effective treatment plans.

Next week our blog will focus on a recent systematic review addressing the treatment of cervicogenic headaches!


1. Walling A. Frequent Headaches: Evaluation and Management. Am Fam Physician. 2020 Apr 1;101(7):419-428. PMID: 32227826.

2. Côté P, Yu H, Shearer HM, Randhawa K, Wong JJ, Mior S, Ameis A, Carroll LJ, Nordin M, Varatharajan S, Sutton D, Southerst D, Jacobs C, Stupar M, Taylor-Vaisey A, Gross DP, Brison RJ, Paulden M, Ammendolia C, Cassidy JD, Loisel P, Marshall S, Bohay RN, Stapleton J, Lacerte M. Non-pharmacological management of persistent headaches associated with neck pain: A clinical practice guideline from the Ontario protocol for traffic injury management (OPTIMa) collaboration. Eur J Pain. 2019 Jul;23(6):1051-1070. doi: 10.1002/ejp.1374. Epub 2019 Feb 28. PMID: 30707486.

3. Fernandez M, Moore C, Tan J, Lian D, Nguyen J, Bacon A, Christie B, Shen I, Waldie T, Simonet D, Bussières A. Spinal manipulation for the management of cervicogenic headache: A systematic review and meta-analysis. Eur J Pain. 2020 Oct;24(9):1687-1702. doi: 10.1002/ejp.1632. Epub 2020 Jul 20. PMID: 32621321.

Please note references are for both image and text.