Good morning Dr. Hollander, I’ve heard Chiropractic helps a lot with headaches. Does it help with Migraine headaches also?

Good morning! Good question. Since I started practice I’ve actually been really fortunate to have helped a lot of people suffering from migraine headaches. I think it’s helpful for people suffering from these headaches to understand them a little better and also the mechanisms by which Chiropractic might affect them. See below for tl;dr. (too long; didn’t read.)

There are many possible mechanisms for Migraines. Commonly refferred to as a “vascular" headache, the cause of migraines is widely thought to be related to the constriction and dilation of blood vessels in the brain.

The mechanism relating to Chiropractic goes like this... Due to a decreased oxygen supply to the brain, arteries in the brain will constrict to increase blood pressure and thereby increase oxygen delivery. Unfortunately in this instance “Innate Intelligence" can “work against" the body, because these arteries may constrict so much that they actually cut off blood flow! This causes an “emergency state" for the body, inducing visual disturbances known as "prodrome," or "aura."

The phenomenon of the prodrome or aura is so diagnostic for migraines that it is referred to as "pathognomonic," meaning that the diagnosis is “beyond any doubt." These visual disturbances may occur before experiencing actual head pain. This is greatly related to the “over-constriction" of arteries in the brain. You know it’s not unlike “seeing stars" when you get up from sitting for a long time. In fact, the physiology of this phenomenon greatly resembles that of a stroke (whoa...). Strokes occur when oxygen to the brain is compromised in a deadly way. Not as deadly, but still relating to brain blood-supply, seeing stars from getting up very quickly, or a prodrome/aura phenomenon follows a similar mechanism to stroke.

It may be counter intuitive, but all this blood vessel constriction isn’t what usually causes head pain. The actual headache follows from a reflexive vasodilation to restore blood flow and oxygen to the brain. This is where the “vascular" or “throbbing" pain of the migraine takes place. Sufferers might describe a “pulsating" feeling in their head and this is usually very painful.

Other common symptoms for migraine sufferers include sensitivity to light and sound, and also nausea. Many people think that because they are simply having a very painful headache, that they are having a migraine. This isn’t always the case because these and other characteristics have to be present for an accurate diagnosis.

How can Chiropractic help with Migraine Headaches?

Well, adjustments have a very strong effect on blood pressure and therefore they can have a profound impact for not only relieving pain from migraine headaches, but also preventing them in the future.

This is because of the effects adjustments have on the sympathetic and parasympathetic nervous systems. The sympathetic nervous system, commonly known as “fight or flight" works to constrict blood vessels to increase blood pressure and oxygen delivery in the presence of a threat or an emergency. The parasympathetic nervous system, otherwise known as “rest and digest" works to dilate blood vessels to decrease blood pressure when the body is in a rested state to deliver nutrients to all the various organs and tissues.

Chiropractic adjustments actually inhibits the sympathetic nervous system and promotes parasympathetic activity. Adjustments decrease the stress response! This occurs due to the increased proprioception in the spine and other joints which the brain actually recognizes as a nutrient. Your body needs to move well for your brain to function well, and your body is in a rested state when your brain is well-nourished.

Another way I help migraine sufferers is by prescribing a nutraceutical grade CoQ10. CoQ10 is a co-enzyme which assists in oxygen delivery and ATP production. By increasing the oxygen content of your cells and the oxygen content of the blood naturally, migraine headaches can be effectively treated and prevented.

tl;dr To summarize, migraine headaches are vascular in nature and relate to the constriction of blood vessels in the brain, which is increased by the sympathetic nervous system or stress response. Chiropractic adjustments effectively treat and prevent migraine headaches by decreasing sympathetic activity, dilating blood vessels, and decreasing the stress response.

(Final note, while this article is scientific in nature, it is not really a referenced article. Therefore it shouldn’t be seen as “proof" or “proving" anything. This is simply my understanding of Chiropractic and migraines. Thanks!)

Hope this helps,

“Chiropractically" yours,

-Darren, DC