Headache & Migraine Relief: Can Physiotherapy Make a Difference?

By Physio Kate

Have you been experiencing headaches or migraines regularly?

Have you been told that “there is nothing you can do for your headaches/migraines except to take medication” - which may or may not work for you,

Or…

“just avoid what triggers your headache or migraine”  - but it seems like there are too many triggers that are too difficult to control?

Maybe it’s time to see if a physiotherapist specifically trained in headache and migraine management can help you manage your symptoms!  Kate at Vital Core Physio and Pelvic Health is one of only two Watson Trained Headache Practitioners in South Australia.  So let's hear her tell us about it.

What is the Watson Approach?

The Watson Headache Approach is a system for assessing and treating the upper neck in relation to headaches and migraines and other symptoms such as dizziness.

This is not just a technique, it’s a system to assess if the neck is involved and which joints in the neck are the most involved, because it isn’t always obvious that the neck is a part of the reason for headaches and migraines.

The upper neck could be involved in your headache because of:

• Poor posture at a desk, on a computer, on a bike, or reading

• Sustained, awkward positions at work, or doing hobbies like sewing or cooking

• Sustained, awkward, repeated movements

• Prolonged stress or emotional tension

• Hormonal changes

• An accident or fall causing whiplash

But how is the neck involved?

It's all about the 'brainstem' (the base of the brain) which 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 is the brainstem the cause for the headache/migraine?

The Watson Approach shows that many headaches and migraines are caused by a "sensitised brainstem" sending exaggerated signals to the brain.

What causes this sensitisation of the brainstem in the first place?

There are a few ways this can happen, but what I see commonly, is people who have tight muscles in one or both sides of their neck causing neck pain 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”. 

Problems in your upper neck may be contributing to almost any type of headache, including those with associated symptoms such as visual changes, brain fog, dizziness and nausea/vomiting.

The Watson Headache Approach is also the only manual therapy technique shown to significantly desensitise the brain stem, where the neck is the cause, reducing headaches within five treatment sessions.

So how does the neck effect the pain I am getting in my eye?

After the brainstem is “sensitised” it sends information further up into the brain more and more frequently. Higher levels of the brain interpret these messages as “abnormal” and create head pain as a result. If we imagine the brainstem is a speaker, when it is sensitised these pain signals cause the speaker to be stuck on the maximum volume and it is now demanding attention!!

I still don’t get how this causes pain in my eye?

These messages cause the brain to create the experience of pain – which you could perceive in your eye.  There’s nothing “wrong” with your eye, and it’s not eyestrain or that you need new glasses – the messaging system is just wound up, or sensitised and that’s where we perceive the pain to be.  This will change depending on which structures are driving the sensitisation the most – which is what we assess and then treat.

What does the treatment involve?

The treatment techniques do not include cracking or jolting or fast movements of your neck.  I use my hands to press on the joints to reproduce your headache symptoms to determine the exact structures involved.  Any increase in symptoms is temporary, and you’ll leave the session feeling better.

 Still have questions/want to know more about this treatment option?

Why not book in to see Kate, our Watson Trained Headache Practitioner, and see if this approach would be right for you? She will be able to tell you whether your upper cervical spine is involved, which levels are involved and lastly if it will respond to this treatment approach.