Headache Guidelines

This section was compiled by Frank M. Painter, D.C.
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Headache Adverse Events Disc Herniation

Chronic Neck Pain Low Back Pain Whiplash Section

Conditions That Respond Alternative Medicine Approaches to Disease

Non-pharmacological Management of Persistent Headaches Associated
with Neck Pain: A Clinical Practice Guideline from the Ontario
Protocol for Traffic Injury Management (OPTIMa) Collaboration

European Journal of Pain 2019 (Jul); 23 (6): 1051–1070

This clinical practice guideline is based on comprehensive literature searches, and its recommendations were developed from high-quality evidence. When developing clinical recommendations, the Guideline Expert Panel considered effectiveness, safety, cost-effectiveness and consistency with societal and ethical values. Moreover, the lived experiences of patients with their care were used when developing recommendations (Lindsay et al., 2016). Our recommendations also included consideration of effect sizes; minimal clinically important differences were used to assess the magnitude of benefit of an intervention on patient outcomes. Finally, the Guideline Expert Panel disclosed any conflicts of interest and maintained editorial independence.

Guideline for the Clinical Management of Persistent
Headaches Associated with Neck Pain
The Ontario Protocol for Traffic Injury Management (OPTIMa) Collaboration 2015~ FULL TEXT

Refer to Section 5 (page 119) for cervicogenic and chronic tension-type headache information.

Evidence-Based Guidelines for the Chiropractic Treatment
of Adults With Headache

J Manipulative Physiol Ther. 2011 (Jun); 34 (5): 274–289 ~ FULL TEXT

Evidence suggests that chiropractic care, including spinal manipulation, improves migraine and cervicogenic headaches. The type, frequency, dosage, and duration of treatment(s) should be based on guideline recommendations, clinical experience, and findings. Evidence for the use of spinal manipulation as an isolated intervention for patients with tension-type headache remains equivocal.

Practitioner guide:

Full guideline


Since 11–24–2016

Updated 7-23-2022

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