Migraine and Headache Treatment with Spinal Manipulative Therapy

Spinal Manipulation Therapy

Sometimes you just need a good pop! For people who haven’t done it before, getting your neck professionally cracked can seem like a very strange idea, but for those who have done it they know just how much pain relief can come from that professional joint manipulation. Interestingly, neck popping, professionally referred to as Spinal Manipulative Therapy (SMT) can be extremely helpful for a specific type of headache called cervicogenic headache.

What is SMT?

Spinal manipulative therapy has been practiced for as far as we can tell thousands of years. It has endured the test of time because so many patients get relief from it. SMT of the cervical spine involves specific movements with varying speeds to increase motion in the joints of the cervical spine. Basically you are unsticking your stuck joints!

How can SMT help cervicogenic headaches?

SMT can help with cervicogenic headaches by returning normal motion to joints, and relieving pain. The irritated structures that are sending pain signals (referred pain) are alleviated, thereby alleviating the headache pain.

What does the research say?

In 2018 researchers from institutions across the USA came together on a study with 256 chronic cervicogenic headache sufferers. The headache sufferers were given either 0, 6, 12, or 18 sessions of SMT vs control groups in a 6 week period. What the study found is that the more treatments patients got, the better the results. The best result was from 18 sessions, resulting in a decrease from 16 headaches per month to 8 headaches per month on average. (1) This is likely one of the best studies on SMT for cervicogenic headache. It is an important guide on how to implement this treatment, and the results that can be expected.

Is SMT safe?

In a paper written by the researchers Swait and Finch which was published in 2017,  they concluded that “Existing literature indicates that benign adverse events following manual treatments to the spine are common, while serious adverse events are rare.” In this paper, they also proposed that “Serious adverse event incidence estimates ranged from 1 per 2 million manipulations to 13 per 10,000 patients.” (2) Overall, this is considered a very safe procedure in the context of treatments for headache and migraine.

Why can’t I just pop my own neck?

Many people pop their neck over and over again only to get a temporary 10 minute relief before they need to pop again. There are many reasons why a professional SMT, and professional examination by your doctor can be superior to self administered neck manipulation. Some common reasons cited include: specificity of treatment, velocity of treatment, and accompanying muscle work or rehab.

Can SMT be performed in addition to my other treatments?

SMT is considered very safe. Not only can it be performed with other treatments, for most patients it is highly suggested that treatments are combined to get the best results. SMT along with rehab exercises, supplements, diet, lifestyle, medications, and other procedures like the Sphenopalatine Ganglion Block, massage, and trigger point injections can all help to bring relief to cervicogenic headache and migraine sufferers. Each migraine and headache patient is evaluated as an individual by Dr. Smitherman.

Does Insurance cover SMT for headaches?

Almost all insurance plans cover SMT including medicare, medicaid in Washington and Oregon, and nearly all private payor insurance companies. Payment by your insurance is subject to your deductible, copay, coinsurance, and rules of your specific plan.

If you think you could benefit from working with Dr. Smitherman please book a free 15 minute consultation or appointment online.


  1. Hass, M., Bronfort, G., Evans, R., et al. Dose-response and efficacy of spinal manipulation for care of cervicogenic headache: a dual-center randomized controlled trial. Spine Journal. 2018 Oct;18(10):1741-1754. doi: 10.1016/j.spinee.2018.02.019. Epub 2018 Feb 23.
  2. Swait, G., Finch, R. What are the risks of manual treatment of the spine? A scoping review for clinicians. Chiropractic Manipulative Therapy. 2017; 25: 37. doi: 10.1186/s12998-017-0168-5