The management of common recurrent headaches by chiropractors: a descriptive analysis of a nationally representative survey

BMC Neurol. 2018 Oct 17;18(1):171. doi: 10.1186/s12883-018-1173-6.


Background: Headache management is common within chiropractic clinical settings; however, little is yet known about how this provider group manage headache sufferers. The aim of this study is to report on the prevalence of headache patients found within routine chiropractic practice and to assess how chiropractors approach key aspects of headache management applicable to primary care settings.

Methods: A 31-item cross-sectional survey was distributed to a national sample of chiropractors (n = 1050) to report on practitioner approach to headache diagnosis, interdisciplinary collaboration, treatment and outcome assessment of headache patients who present with recurrent headache disorders.

Results: The survey attracted a response rate of 36% (n = 381). One in five new patients present to chiropractors with a chief complaint of headache. The majority of chiropractors provide headache diagnosis for common primary (84.6%) and secondary (90.4%) headaches using formal headache classification criteria. Interdisciplinary referral for headache management was most often with CAM providers followed by GPs. Advice on headache triggers, stress management, spinal manipulation, soft tissue therapies and prescriptive neck exercises were the most common therapeutic approaches to headache management.

Conclusion: Headache patients make up a substantial proportion of chiropractic caseload. The majority of chiropractors managing headache engage in headache diagnosis and interdisciplinary patient management. More research information is needed to understand the headache types and level of headache chronicity and disability common to chiropractic patient populations to further assess the healthcare needs of this patient population.

Keywords: Cervicogenic headache; Chiropractic; Manual therapy; Migraine; Practice-based research network; Spinal manipulation; Tension headache.

MeSH terms

  • Chiropractic / statistics & numerical data*
  • Chronic Disease
  • Cross-Sectional Studies
  • Delivery of Health Care / statistics & numerical data
  • Female
  • Headache / therapy*
  • Health Personnel / statistics & numerical data*
  • Humans
  • Male
  • Prevalence
  • Referral and Consultation / statistics & numerical data
  • Surveys and Questionnaires