Soft Tissue Chiropractic Techniques for Migraines

Headaches affect nearly half of all adults in their lifetime [7]. Migraine headaches account for 69% of all primary headaches, which are defined by the International Headache Society as headaches “in which the pain is caused by independent pathologic mechanisms” [7]. An estimated 15% of people worldwide are said to have one-year prevalence of migraine [1,3], making it “19th among all causes of years lived with disability,” according to the World Health Organization, and the seventh highest cause of disability in a study performed by the Global Burden of Disease [1].  Chiropractic techniques are an effective treatment for migraine.

As explained by Espí-López et al., migraine is considered a neurovascular disorder, originating “in the sensory fibers that convey pain signals from intracranial and extracranial blood vessels” [5]. Factors resulting in migraine sometime include “changes in atmospheric pressure, intake of certain foods, certain drugs, psychological factors, sleep disturbance, or stress” [5]. While multiple medications have been shown to help treat migraine (e.g., Amitriptyline), their many unwanted side-effects (fatigue, dizziness, low blood pressure, depression, and renal damage) [7] “has led to a growing demand for nonpharmacological prophylactic treatments to reduce the frequency of migraine” [1]. 

One nonpharmacological approach to migraine treatment is through chiropractic care. In fact, in a study performed in 2011 by Bryans et al., headache was listed as the third most common reason for patients seeking chiropractic care in North America [3]. Various studies find spinal manipulation therapy, in which “an examiner applies a manual force to a spinal joint to move the joint near its end range of motion” [8], as being equally effective for migraine treatment as Amitriptyline, but without the unwanted side-effects [2,3,6,7,8]. Occipital decompression, a chiropractic technique that involves “using the fingertips to manually stretch the paraspinal tissues at the base of the occiput,” has also been shown to help manage pain and discomfort from migraine [6].  

People with migraine disorder often show postural deficiencies and complain of tension and pain in the neck muscles associated with myofascial trigger points (MTrPs) [7]. In turn, researchers believe MTrPs contribute to the prevalence of migraine headaches [7]. Current non-pharmacological methods for mitigating MTrPs in patients with migraine include laser therapy, needling therapies (such as acupuncture), and soft tissue techniques [7,8]. Although soft tissue techniques focusing on MTrPs have been said to effectively treat migraine [7], the study performed by Espí-López et al. saw greater efficacy when they were combined with suboccipital soft tissue inhibition [5]. Several studies also examine the use of osteopathic therapy, such as soft tissue massage of the paraspinal tissues, for migraine relief [3,6]. One study cites that “the use of 8 osteopathic sessions over a 6-month period significantly reduced the use of drugs, pain, and disability” among patients with migraine [4].   

Research has demonstrated that soft tissue chiropractic techniques can indeed improve the quality of life for patients suffering from migraine and are an effective and safe alternative to pharmacological intervention. This is a promising research avenue to pursue in developing guidelines for headache prevention and treatment. 


  1. Amons, A. L., Castien, R. F., van der Wouden, et al. (2019). Manual Therapy as a Prophylactic Treatment for Migraine: Design of a Randomized Controlled Trial. Trials, 20(1), 1–9. doi:10.1186/s13063-019-3937-8  
  1. Biondi, D. M. (2005). Physical Treatments for Headache: A Structured Review Headache, 6, 738. doi:10.1111/j.1526-4610.2005.05141.x  
  1. Bryans, R., Descarreaux, M., Duranleau, M., et al. (n.d.). (2011). Evidence-Based Guidelines for the Chiropractic Treatment of Adults with Headache. Journal of Manipulative and Physiological Therapeutics, 34(5), 274–289. doi:10.1016/j.jmpt.2011.04.008  
  1. Cerritelli, F., Emanuele, C., Rina, G. L., Gabriella, M., Marcello, D. V., & Luca, M.. (n.d.). Is osteopathic manipulative treatment effective in migraine? International Journal of Osteopathic Medicine, 16(1), e15–e16. doi:10.1016/j.ijosm.2013.01.008  
  1. Espí-López, G.-V., Ruescas-Nicolau, M.-A., Nova-Redondo, C., et al. (2018). Effect of Soft Tissue Techniques on Headache Impact, Disability, and Quality of Life in Migraine Sufferers: A Pilot Study. Journal of Alternative & Complementary Medicine, 24(11), 1099–1107. doi:10.1089/acm.2018.0048  
  1. Keays, A. C., Neher, J. O., & Safranek, S. (2008). Is Osteopathic Manipulation Effective for Headaches? Journal of Family Practice, 57(3), 190–191. PMID:18321458  
  1. Rezaeian, T., Mosallanezhad, Z., Ahmadi, M. et al. (n.d.). The Impact of Soft Tissue Techniques in the Management of Migraine Headache: A Randomized Controlled Trial. Journal of Chiropractic Medicine, 18(4), 243–252. doi:10.1016/j.jcm.2019.12.001  
  1. Smith, M. S., Olivas, J., & Smith, K. (2019). Manipulative Therapies: What Works. American Family Physician, 99(4), 248–252. PMID:30763049