Millions of Americans visit medical doctors each year complaining of migraines and hoping for a quick fix to their sometimes debilitating problems. Not surprisingly, most patients are sent home after a minimal exam with a prescription for pain medication. Unfortunately not a lot of thought is given to the root cause of pain when prescribing medications. Did they consider a chiropractor?

Although migraines often resemble other types of headaches, migraines are classified as primary headaches by the International Classification of Headache disorders 3rd Ed. In the Global Burden of Disease Study 2010 (GBD2010). Migraine was ranked as the third most prevalent disorder in the world. In GBD2015, it was ranked the third-highest cause of disability worldwide in both males and females under the age of 50 years. (1)

Anyone experiencing migraines on a regular basis will confirm how disabling they can be. There are four phases involved with migraines: prodrome, aura, headache, and postdrome. Although not all migraines involve all four phases, most patients will experience a combination of these symptoms. (2)

Migraine Phase 1: Prodrome
Most migraines are preceded by a specific phase called the prodrome, and it may occur hours or days before the actual headache. During this phase, sufferers may experience depression, food cravings, neck stiffness, nausea, hyperactivity or fatigue.

Migraine Phase 2: Aura
This is a collection of neurological symptoms that usually involve a person’s visual experience such as flashing or wavy lights. Other symptoms of an aura may include things like strange smells, tingling sensations and cognitive difficulties. Approximately 20% of patients with migraines experience an aura, and it’s likely to occur shortly before the onset of the headache. (7)

The prodromal and the aura phases are warnings that a migraine coming. Taking action and having the neck and spine adjusted by your chiropractor can lessen and sometimes avoid the more painful stages of this type of headache.

Migraine Phase 3: Headache
The main characteristics of the headache phase are… Moderate to intense pain with a pulsating quality that lasts 4 to 72 hours. A typical migraine sufferer may find a dark, quiet room and rests there until the pain subsides. Migraines may be aggravated by:

  • Bright light
  • Loud noise
  • Nausea and vomiting
  • Depression and severe anxiety
  • Hot flashes and chills
  • Dizziness
  • Confusion
  • Dehydration or fluid retention

Migraine Phase 4: Postdrome
Pain has now subsided, but most sufferers will tell you the migraine episode is definitely not over. The postdrome phase may take hours or days to complete and some patients will describe it as the effect of having a hangover. During this time, a migraine sufferer may experience…

  • Low mood, or depression feeling
  • Feelings of euphoria and well being
  • Low energy and Fatigue
  • Poor concentration and comprehension

What Is a Migraine, and What Causes It?
Migraines differ from other headaches because their phases and the painful phase of the migraine is almost always associated with other bodily symptoms. Researchers have noted that certain people experience blood vessel contractions and dilations in the brain just prior to a migraine occurring.

Although vascular changes in the brain have been considered as contributory, medical doctors often miss the fact that blood flow to the brain is significantly altered by poor neck postures. (3) As structurally trained chiropractors, Dr. Leatherman and Dr. Bak will look to fully examine and x-ray the neck as research has confirmed that loss of the neck curve is a big factor in tension and migraine headaches. (4, 5, 6)
Common triggers for migraine headaches include:

  • Stress
  • Poor posture
  • Lack of sleep
  • Loss of the neck curve
  • Changes in weather
  • Environmental chemicals
  • Liver problems
  • Rapid change in hormone levels
  • Dental pain
  • Certain foods (cured meat, onion, eggs, nuts, cheese)
  • Red wine and other alcohols
  • Medical conditions (depression, severe hypertension)
  • Medications

How Does Integrity Chiropractic Treat a Migraine?
Published studies show chiropractic adjustments as a very effective tool used to treat migraine headaches. (7, 8) Often chiropractic adjustments result in instant and significant relief, but most cases require ongoing care to manage painful episodes.
At the Integrity office, Dr. Leatherman and Dr. Bak also utilize, posture based corrective exercises and CBP structural rehabilitation traction techniques due to their published data on eliminating poor postures and significantly reducing headache symptoms. (9, 10)
For severe cases where patients cannot endure the painful stages of a migraine, Dr. Leatherman and Dr. Bak may refer and co-manage with a medical doctor for migraine specific medications. This can aid in the ability to complete a proper active based rehab program.


  1. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018, Vol. 38(1) 1–211
  2. Edmeads J, Findlay H, Tugwell P, Pryse-Phillips W, Nelson RF & Murray TJ. Impact of migraine and tension-type headache on life-style, consulting behaviour, and medication use: a Canadian population survey. Can J Neurol Sci. 1993; 20(2): 131-137.
  3. Katz EA, Katz SB, Fedorchuk CA, Lightstone DF, Banach CJ, Podoll JD. Increase in cerebral blood flow indicated by increased cerebral arterial area and pixel intensity on brain magnetic resonance angiogram following correction of cervical lordosis. Brain Circ 2019;5:19-26
  4. Bronfort G, Assendelft WJ, Evans R, Haas M & Bouter L. Efficacy of spinal manipulation for chronic headache: a systematic review. J Manipulative Physiol Ther. 2001; 24(7): 457-466.
  5. Vernon H, Steiman I, Hagino C. Cervicogenic dysfunction in muscle contraction headache and migraine: a descriptive study. J Manipulative Physiol Ther. 1992 Sep;15(7):418-29.
  6. Watson DH1, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia. 1993 Aug;13(4):272-84; discussion 232.
  7. Tuchin PJ, Pollard H, Bonello R. A randomized controlled trial of chiropractic spinal manipulative therapy for migraine. J Manipulative Physiol Ther 2000;23(2):91-95.
  8. Tuchin PJ. A case of chronic migraine remission after chiropractic care. J Chiropractic Medicine. 2008; 7(2): 66-70
  9. Fortner M, Oakley P, Harrison, D. Alleviation of chronic spine pain and headaches by reducing forward head posture and thoracic hyperkyphosis: a CBP® case report. J Phys Ther Sci. 2018 Aug; 30(8): 1117–1123.
  10. Fortner M, Oakley P, Harrison, D. Cervical extension traction as part of a multimodal rehabilitation program relieves whiplash-associated disorders in a patient having failed previous chiropractic treatment: a CBP® case report. J Phys Ther Sci. 2018 Feb; 30(2): 266-270.