New Clinical Practice Guideline for the Chiropractic Management of Cervicogenic and Tension-Type Headaches
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Clinical Compass has announced via a press release on February 19, 2026, a new clinical practice guideline that has been published in the Journal of Integrative and Complementary Medicine.
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Press Release
Clinical Compass is proud to announce a new clinical practice guideline by Trager et al. has been published in the Journal of Integrative and Complementary Medicine.
A 57-member Delphi panel agreed on statements encompassing a whole encounter related to management of adults with cervicogenic and tension-type headaches. Tension-type headaches are a primary headache, whereas cervicogenic headaches are a secondary headache due to cervical spine disorders. The consensus statements address history taking, physical examination, imaging, contraindications, care management, and nonpharmacological treatments related to headache care delivered by chiropractors.
This guideline endorses establishing a working diagnosis using the Third Edition of the International Classification of Headache Disorders, and assessment of red, orange, and yellow flags. It strongly recommends spinal manipulation for cervicogenic headache, and it recommends spinal manipulation in combination with joint mobilization, soft tissue techniques, and/or modalities for tension-type headache. Beyond the scope of the study’s objective, this guideline did not address migraines, although migraine features may overlap with cervicogenic or tension-type presentations.
This paper is freely available open access on the journal website: CLICK HERE Please read it and share it with stakeholders in your local region. This work was supported in part by the Clinical Compass.
Clinical Compass is a chiropractic clinical and research collaborative that generates best practices research through consensus-based models. In addition, Clinical Compass maintains a Scientific Commission, a 28-member team of leading US chiropractic scientists and clinician-scientists. In addition, Clinical Compass maintains regularly updated evidence centers for 17 different clinical topics such as dry needling, opioids, and cost-effectiveness. To support the work Clinical Compass, please go here: Donate – The Clinical Compass
Citation:
Trager RJ, Daniels CJ, Hawk C, Taylor DN, Walters SA, Price MR, Anderson KR, Crivelli LS, Mooring SA, Staab CA, Oakley CB. Chiropractic Management of Adults with Cervicogenic or Tension-Type Headaches: Development of a Clinical Practice Guideline. J Integr Complement Med. 2026 Feb 13:27683605251397769. doi: 10.1177/27683605251397769. PMID: 41685545.
