Migraine Headache Prevention

Migraine headache is defined as recurrent/episodic moderate or severe headaches which are usually unilateral (one side of the head), pulsating, aggravated by routine physical activity, and are associated with either nausea, vomiting, photophobia (sensitivity to light), or phonophobia (sensitivity to sound) [1,2].


Diagnosis of migraine headaches is made primarily from the patient’s history and a negative neurological exam. Neuroimaging is only indicated in patients with a positive neurological exam or presence of a “red flag” (warning signs suggesting a more serious medical condition) [2]. Chiropractors are well trained to take a thorough history and perform a neurological examination. If we detect any signs that your condition is more suitable for medical treatment we will recommend a referral to your GP.

Evidence based summary for manual therapy

Randomised controlled research trials show moderate quality evidence (on a scale of inconclusive, moderate and high) that spinal manipulative therapy has an effectiveness similar to a first-line prophylactic (preventitive) prescription medication (amitriptyline) for the prophylactic treatment of migraine [7].

Other evidence based effective non-invasive physical treatments or patient education

Trigger avoidance, stress management, acupuncture, biofeedback [2,8,9]

Back-in-Action clinical comment

In our experience the prevention of migraine headaches in particular require a truly holistic approach to increase the probability of a good result. Our approach often incorporates a combination of spinal manipulation, mobilisation, muscle release techniques, neck exercises, referral for massage therapy, diet and nutritional advice, acupuncture (dry needling), functional neurological exercises, cranial work, cryotherapy (heat and/or ice), postural improvements, ergonomic advice and relaxation counselling.

From the Preston Chiropractor Team
Getting You Back in Action & Enjoying Your Life Again
Serving the people of Preston and surrounding areas including Southport and Lytham St Annes