There are many different types of headache some of which are less likely to be helped by manual therapies like chiropractic. Fortunately the most common type of headaches by far are tension type headaches, along with cervicogenic headaches these are perfectly suited conditions to be helped by chiropractic treatments like manipulation, massage, dry needling and exercise.
Tension type headaches & cervicogenic headaches are a result of aberrant pain signalling to the brain from either trigger points in the neck muscles or nerve irritation around the joints of the neck. They respond well to the same treatments as standard mechanical neck pain so for further information on treatments/exercise for these see the neck pain page.
Migraines are the next most common type of headache and although nothing can cure migraines manual therapies are just as effective as pharmaceutical drugs at reducing the frequency of attacks and level of pain. Some people choose to manage their migraines with medications, several types of medication have been studied and none of them really stand out above the others or manual therapy.
Ibuprofen (400mg) & sodium valproate may be the most effective but different mediations will work for different people and finding the ones that minimise the inevitable side effects is also an important point to consider. Flunarizine is growing in popularity due to some recent studies but it has not yet been shown to be any more effective than over the counter meds like ibuprofen, weight gain is a significant side effect.
NICE suggest trying a course of acupuncture up to 10 sessions over a 5-8 week period for prophylactic treatment of chronic tension type headache. For migraine prophylaxis they suggest starting with topiramate or propranolol and if they don’t work trying either acupuncture or gabapentin. NICE also note that 400mg of riboflavin supplement may help. These guidelines were last updated 2012.
Please remember headaches can be made worse by taking medication too often. The best “natural” ways to control headaches are to look for the musculoskeletal and/or nutritional triggers. Many people find a significant reduction in migraines by avoiding certain foods & drinks such as chocolate, wine, gluten based foods, high sugar foods, dairy foods and several other foods. Getting a regular sleep pattern along with overall good sleep hygiene is also likely to help.
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