Migraine Headache

The research suggests yes — with realistic expectations. Several randomized controlled trials have found that cervical spinal manipulation reduces migraine frequency by roughly 40–50% on average, with effects comparable to some preventive medications. Chiropractic is not a cure for migraine — it's a neurological condition with genetic underpinnings — but it can meaningfully reduce the cervicogenic and musculoskeletal trigger load that contributes to migraine frequency in many patients. We're clearest about what we can offer and will always co-manage with neurology when preventive or abortive medication is appropriate.

A trigger is anything that moves you closer to your migraine threshold — the point at which your sensitized nervous system initiates an attack. Triggers include disrupted sleep, skipped meals, dehydration, hormonal fluctuations, bright or flickering light, strong smells, alcohol (especially red wine), aged cheeses, weather changes, and physical or emotional stress. The key insight is that triggers are cumulative: a single trigger may not cause a migraine on its own, but two or three together often will. Keeping a headache diary for four to six weeks is the most effective way to identify your personal pattern — we review this together and it often reveals patterns patients hadn't noticed.

This is the "let-down headache" pattern, and it's one of the most reliably described migraine phenomena. During a stressful week, elevated cortisol and sustained sympathetic nervous system activation hold the migraine threshold in check. When stress drops abruptly — the first morning you sleep in, the first day of vacation, a Saturday after a demanding week — cortisol levels fall quickly and the threshold drops with them, triggering the migraine. The practical takeaway is that maintaining a reasonably consistent sleep schedule, even on weekends, reduces this pattern significantly.

Yes — and this is one area where the evidence is stronger than many patients expect. Magnesium glycinate or citrate (400 mg daily) has consistent evidence for migraine prevention, particularly for menstrual migraine; it's thought to work through its effect on cortical spreading depression and neurovascular regulation. Riboflavin (vitamin B2, 400 mg daily) has randomized trial support for reducing migraine frequency. CoQ10 also has modest evidence. These are not replacements for medical management in frequent or severe migraine, but they're genuinely useful adjuncts with a low risk profile that we discuss as part of our nutrition counseling.

Aura refers to reversible neurological symptoms — most commonly visual disturbances like zigzag lines, flashing lights, or a spreading blind spot — that precede the headache phase by 5 to 60 minutes. These reflect a wave of electrical and metabolic activity (cortical spreading depression) moving across the brain. The distinction matters more medically than it does for chiropractic care: migraine with aura carries a slightly elevated cardiovascular risk, which affects decisions about certain hormonal contraceptives and some medications. From a chiropractic standpoint, the cervicogenic component and treatment approach are similar; the aura itself is a neurological phenomenon we don't directly treat.