Prevalence of headache consultations in Danish chiropractic practice: A cross-sectional study

BackgroundHeadache is a leading cause of disability and a major public health problem worldwide. Although most patients with headaches are managed in primary care settings, including chiropractic clinics, there are few studies describing the prevalence of headache and headache diagnoses in primary care. The present study aimed to: (1) estimate the prevalence of headache consultations in chiropractic practice; (2) estimate the prevalence of different headache diagnoses used in chiropractic practice; and (3) determine the association between the prevalence of headache consultations and chiropractor characteristics.MethodsAll chiropractors in Denmark, who were members of the Danish Chiropractic Association, (n = 695) were invited to participate. Data collection for this cross-sectional study was based on a survey and a 20-day logbook and took place in 2022. The survey collected information on various characteristics of the chiropractors who completed the logbook. The logbook recorded the total number of consultations, whether the reason for the consultation was related to headache, the type of diagnosis, the type of consultation (e.g. new patient, maintenance care), and whether the headache was the primary or secondary reason for the consultation. We used weighted linear regression analyses with robust standard errors for determining associations between prevalence and chiropractor characteristics.ResultsIn total, 76 chiropractors participated, reporting a prevalence of 12% for consultations including any type of headache. The response rate was 10.9%. The prevalence of headache-related consultations per chiropractor varied from 0% to 38% (median = 12.1; interquartile range = 8.2-15.5). In 43.6% of all headache consultations, headache was the main reason for consulting a chiropractor. The most common type of headache was tension-type (36.2%), followed by combinations of headache types (34.4%), with the most common combination being tension-type and cervicogenic headache. Headaches were reported in 12% of all new consultations and 25% of all maintenance care consultations. There were no associations between the prevalence of headache consultations and chiropractor characteristics.ConclusionsPatients with headaches, especially tension-type headaches and patients with more than one type of headache, were common in chiropractic clinics, with 12% of all consultations related to headaches. In two out of every five consultations related to headaches, the headache itself was the primary reason for visiting the chiropractor, rather than a secondary symptom accompanying another condition such as neck pain. No specific characteristics of chiropractors were associated with the frequency of headache consultations. This study may raise awareness of headache patients seeing chiropractors and help understand their healthcare needs.