Can a Chiropractor Help Migraines? What to Expect in St. Paul

People who come to see me about migraines have usually been dealing with them for years. Most have seen their doctor, tried two or three medications, cut out red wine or aged cheese, and still lose several days a month to a dark room and an ice pack. By the time they search for a chiropractor for migraines, they want to know one thing: is this worth trying, or is it another thing that won’t work?

My answer is that chiropractic care helps some people with migraines quite a bit, helps others a little, and doesn’t do much for some. It isn’t a cure, and anyone who tells you that shouldn’t be trusted with your head. Below I’ll explain why the neck matters in migraine, who tends to do well with our care, what a visit actually looks like, and how we figure out together whether it’s working.

Migraine Is a Brain Condition, but the Neck Is Involved

A migraine starts in the brain and the nerves around it. That’s why it brings so much more than head pain: sensitivity to light and sound, nausea, and for some people an aura of zigzag lines or blind spots before the pain starts. It also tends to run in families. Chiropractic care doesn’t change the fact that your nervous system is wired to have migraines.

What it can affect is one of the things that sets them off or keeps them going. The nerves from the top three joints of your neck feed into the same relay center in the brainstem as the trigeminal nerve, which carries most of the pain signals from your head and face. Those signals share wiring. So when the upper neck is stiff and the muscles at the base of the skull are irritated, that steady input can lower the threshold for an attack, or make one hang on longer.

That matches what migraine patients tell me. Most of them have neck pain or tightness with their attacks, and many feel it coming on in the neck before the headache arrives. Some notice that a long day hunched over a laptop, or a bad night of sleep with their neck twisted on the pillow, is reliably followed by a migraine. Those are the people I’m most hopeful for.

If you aren’t sure whether your headaches are true migraines or are coming from the neck itself, our post on cervicogenic headache vs. migraine walks through the differences. Plenty of people have both.

Who Tends to Do Well With Chiropractic Care

Over the years, I’ve noticed that patients who get the most out of care usually have a few things in common:

• Neck pain, stiffness, or tight shoulders that show up with or before their migraines
• Attacks that follow long stretches at a desk, driving, or poor sleep
• Jaw clenching or teeth grinding, which loads the same muscle groups.
• A history of whiplash or another neck injury before the migraines got worse
• Headaches that are partly migraine and partly tension or neck-related

People whose migraines are clearly tied to hormones, specific foods, or other triggers with no neck involvement tend to see less change from what we do. I’ll still check their neck, because a lot of people have more going on there than they realize, but I’ll be upfront if I don’t think we’re the right fit.

What the Research Says

The research here is mixed, and I’d rather you hear that from me than find out later. Some small clinical trials have found that spinal manipulation reduced the number of migraine days and how bad the attacks were for some participants, and a few reviews that pooled those trials came to similar conclusions. The studies are small, though, and the quality varies, so nobody can say for certain how much benefit to expect. There’s also some evidence that massage helps with migraine frequency and sleep, and fairly good evidence that regular aerobic exercise cuts down on attacks for many people.

In practice, that means chiropractic care is a reasonable thing to try alongside your medical care, especially if your neck is part of the picture. It isn’t a reason to stop your medications or skip your doctor. If you take a daily preventive medication, keep taking it while we work, and talk to your doctor before changing anything.

When a Headache Needs a Doctor First

Some headaches aren’t migraines at all and need medical attention right away. Go to the emergency room or call 911 if you have:

• A sudden, explosive headache that hits its peak within a minute or so
• The worst headache of your life
• Headache with fever, a stiff neck, confusion, or a rash
• New weakness, numbness, trouble speaking, or loss of vision that isn’t your usual aura
• A headache after a fall, a blow to the head, or a car accident

Also see your doctor soon if your headaches have changed pattern, started after age 50, wake you up at night, or keep getting worse. In those cases, imaging or other tests come before anything we would do.

What a Visit for Migraines Looks Like

The first visit is mostly questions and an exam. I want to know how often you get migraines, how long they last, what tends to set them off, which medications you’ve tried, and whether your neck, shoulders, or jaw get involved. Then I check how your neck moves, test the nerves and reflexes in your arms, and feel the joints at the top of the neck and the muscles at the base of your skull. I’ll also look at your jaw, because clenching shows up in a lot of migraine patients.

If treatment makes sense, it usually combines a few things. For the joints, I use gentle adjustments to the upper neck and upper back. Not everyone wants or needs a quick, hands-on adjustment of the neck, and for some patients I use slower mobilization or an instrument instead. For the muscles, our massage therapist Joy Vang works on the base of the skull, the neck, the shoulders, and the jaw. Tight masseter muscles are a common finding, and loosening them helps more people than you’d expect.

The last piece is what you do between visits. We’ll look at how your screen sits on your desk, your pillow, and when you take breaks. I’ll give you a few neck exercises to strengthen the deep muscles at the front of your neck, which tend to get weak when your head drifts forward all day. These are small changes, but they’re what keep the neck from slipping back into the same pattern.

How We Know Whether It’s Working

Migraines come and go on their own, so it’s easy to fool yourself in either direction after one good or bad week. That’s why I ask migraine patients to keep a simple headache diary. Write down each day you have a headache, how bad it was on a scale of 1 to 10, how long it lasted, and whether you took medication. It takes about 30 seconds a day.

We’ll usually start with two or three visits a week for the first few weeks, then space them out as you improve. After six to eight weeks, we compare your diary to how things were before you started. What I’m looking for is fewer migraine days in a month, shorter attacks, or attacks that respond better to your medication. If none of those have changed, we stop, and I’ll tell you so. If they have, we work out how much ongoing care you actually need, which for many people ends up being a visit every few weeks.

Finding a Migraine Chiropractor in the Twin Cities

If you’re searching for a migraine chiropractor near you, or the best chiropractor for migraines in the Twin Cities, ask a few questions before you book. Will they examine you and ask about your medical history before treating? Do they use gentler options for the neck if you’d prefer them? Will they work with your doctor or neurologist? Any office that promises to cure your migraines, or asks you to stop your medications, isn’t the right one.

We see people from all over St. Paul and the Twin Cities for migraines and other headaches. Some find their attacks pick up with Minnesota’s weather swings, the dry indoor air of winter, or the long dark months when everyone spends more time inside on screens. You can read more about how we treat all kinds of headaches on our headache chiropractor page.

Get Help With Your Migraines

If migraines are costing you days every month and your neck seems to be part of it, call Twin Cities Chiropractic at (651) 224-1921 or stop by 506 N. Lexington Pkwy, St. Paul, MN 55104. Bring a list of your medications and, if you have one, your headache diary.

Frequently Asked Questions

1. Can a chiropractor help with migraines?
   It depends on what’s driving yours. When the neck or jaw is part of what sets off your attacks, a lot of my patients end up with fewer migraine days and attacks that don’t last as long. If your migraines are mostly tied to hormones or food, I’m less likely to make much of a difference, and I’ll tell you that at the first visit. Either way, it’s something to add to your medical care, not use instead of it.
2. How many visits does it take to see a difference?
   Give it a few weeks before you decide. We usually see people two or three times a week at the start and then spread the visits out. Around the six to eight-week mark, we sit down with your headache diary and compare it to how things were before you started.
3. Should I come in while I have a migraine?
   I usually wouldn’t. Most people feel too sick to get in the car, and the lights and moving around on the table don’t help. The care does more good between attacks, when we’re trying to cut down how often they come.
4. Is it safe to have my neck adjusted if I get migraines?
   For most people, it is, once we’ve done a proper exam and gone over your history. Serious problems from neck adjustments are rare. If the idea of a quick adjustment makes you nervous, just say so. There are slower, gentler ways to work on the neck, and plenty of my migraine patients prefer them.
5. Can I keep taking my migraine medication?
   Yes, please keep taking it. Don’t stop or change anything without talking to your doctor first. If your migraines get better over time, your doctor is the one to decide whether the medication can change.