Are you getting Triggered? Understanding the difference between triggers and causes of headaches and migraines

Are You Getting Triggered?

Understanding The Difference Between Triggers vs Cause of Headaches and Migraines

By Physio/ Watson Practitioner Kate

Do you love red wine, chocolate or cheese but can’t eat/drink it because it will cause a headache or migraine?

Or do you dread certain times of your menstrual cycle as you know that it will cause a headache that occurs like clockwork?

You will have noticed I have highlighted the word “cause”, and this is because I have some important news for you…

"Your period, what you eat, your lack of sleep, those loud noises, or unpleasant smells or even your emotional state IS NOT WHAT CAUSES YOUR HEADACHES"

These are called triggers and I will repeat it again, these are NOT the cause of your headaches/migraines!

What is the difference between a trigger and the cause?

A trigger is something that happens to set off a response in the brain that results in headache/migraine- for example:

• Environmental Factors: Bright lights, loud noises, strong smells, and changes in weather

• Hormonal Changes: changes in your hormones, especially when estrogen levels take a nosedive right before your period starts can trigger “menstrual migraines” in some individuals. This may also happen during your ovulation or “fertile” cycle of your cycle when that hormone estrogen is ramped up.

• Dietary Triggers: Certain foods and beverages, such as aged cheeses, processed meats, chocolate, caffeine, and alcohol

• Stress and Emotional Factors: Emotional stress, anxiety, and general tension

The cause of your headache/migraines is due to the “sensitisation” of the brainstem.

From my previous blog: The 'brainstem' (the base of the brain) is located at the top of your neck.  Its job is to gather information from your face, head, and neck, from the blood vessels, nerves, joints, and muscles. It then sorts and sends this information to the brain for processing.

How does the brainstem become sensitised?

There are a few ways this can happen, but what I see commonly, is people who have tight muscles on one or both sides of their neck causing neck pain and/or stiffness. Pain signals are then sent to the brainstem.  If that signal keeps happening over weeks and months and years, the brainstem becomes a bit overstimulated, or “sensitised”.

Let me put this another way.

Have you noticed when you have stubbed your toe after having a good day you are annoyed and it hurts a bit, but you move past it quickly? Now let’s imagine you have a really bad day at work or school, you are really emotional and everything seems to be going badly. Then to top it off you stub your toe. This is where the tears and the swearing and the rhetorical “can anything else go wrong today!”  starts. Why is this? Because after a bad day your nervous system is already “primed” to react badly to a minor incident, although it sure doesn’t feel minor at the time!

Let’s put this into context with headaches and migraines. The headache and migraine triggers are the “stubbing of the toe” and the brainstem being not sensitised/sensitised is the “good vs bad day you have been having”.

According to the evidence supplied by Dr Dean Watson (of Watson Headache Institute), if the brainstem is NOT sensitised (a good day) and you eat some cheese (stubbing your toe) you have a normal reaction - no headache or migraine (no swearing!). However, if the brainstem is sensitised and you eat cheese you are more likely have an abnormal/overreaction (headache/migraine) to the same stimulus.

So we understand the sensitisation of the brainstem is the cause - how do we fix this?

Desensitising the brainstem

While many individuals turn to medication to reduce these headache and migraine symptoms, we as physiotherapists offers a holistic approach to managing these conditions. Physiotherapists use a variety of techniques to calm down the muscles and joints in your neck and therefore desensitising the brainstem.

One of the better-known techniques is the Watson Headache Approach. This involves a particular technique to the upper neck to reduce your headache symptoms. 

The Watson Headache Approach uses gentle, hands-on techniques to help relax the muscles and joints in your upper neck. Whilst it may at first appear to be similar to traditional physiotherapy, it is in fact a specific system to assess firstly if the neck is involved and secondly, which joints in the neck are the most involved. This has been scientifically shown to assist many people suffering from headaches and migraines.

The Watson technique reduces the physical tension and pressure that can make your brainstem go haywire during a headache/migraine.  I use my hands to press on the joints to reproduce your headache symptoms to determine the exact structures involved with absolutely no cracking. 

So if the Watson Headache Approach is effective for me in desensitizing the brainstem, I can have a glass of wine will I NOT get a headache???

YES!!!! That’s the idea! If you have a good day and stub your toe it’s nothing you can’t shake off!

Let’s give you some good days!  

Call the clinic on 8331 0552 or book online to see Kate for a thorough assessment to see if the Watson Headache Approach will work for you.