Sensitisation in Headache and Migraine

I have mentioned in my previous blogs that sensitisation of the brainstem has been demonstrated in migraine, tension headache, menstrual migraine and cluster headache. What I may not have made clear is that this sensitised state is present even when you are free of your headache or migraine, that is, your brainstem is sensitised constantly. Then what happens is that you eat or drink something, your hormonal levels change, you smell a perfume – and this triggers your headache or migraine. These events lead to increased (but normal) activity of structures (including blood vessels) inside your head. This increased activity is wrongly interpreted as being much more than what it actually is and pain results. If it wasn’t for your sensitised brainstem, what you eat, drink, smell or hormonal fluctuations would not result in the disabling headache or migraine.

If you are going to be free of your headache or migraine, the source of sensitisation has to be determined. Whilst the triptans desensitise the brainstem and are effective for many of you, they do not eliminate the cause of the sensitisation. Information from neck disorders can sensitise the brainstem and of all the various investigations you may have for your headache of migraine, a skilled examination of your upper neck is relatively inexpensive and non invasive, and may change your life
significantly.

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YourHeadacheSoultions.co.uk is one voice of the Watson Headache Institute. The Watson Headache Institute was established to increase the awareness of cervicogenic (neck) disorders in headache and migraine by imparting my (and that of others) clinical experience and knowledge; to present and discuss past and present relevant research and to undertake and support rigorous clinical and scientific research in this specialty. Appropriate and up-to-date knowledge is self-empowering; I believe that every headache  sufferer has the right to know their headache diagnosis as precisely as possible (and what it means), to know the nature of their headache disorder, its outcome and possible types of
treatment.

What has yet to gain acceptance is my (and that of others) belief, supported by my unparalleled clinical experience and a significant body of international research, that it is incorrect to consider headache and migraine types as totally different entities and that cervicogenic (neck) disorders can be instrumental in the headache and migraine process. Although Physiotherapy, Chiropractic and Osteopathy are different disciplines, we are supporters of the idea that headache and migraine sufferers, no matter what their diagnoses, can be helped to live their lives more effectively through appropriate neck treatment. However, because treatment of the neck does not fit the medical model of headache and migraine, the model has demonstrated little interest in exploring this as an option. It is
essential that all factors, which have the potential to sensitise the brainstem, be investigated equally.  Currently this is not the situation – the neck is largely disregarded.

So, whilst YourHeadacheSolutions.com is also about Education, it is also a directory for headache and migraine sufferers to source practitioners who have a particular interest in and are skilled in examination of the neck as a source of your headache or migraine – to create a more comprehensive approach and provide an alternative, medication-free treatment. Over the past 15 years I have developed a series of techniques, which, by way of temporary reproduction of headache and easing of the headache as a technique is sustained, confirm that a neck disorder is the cause of or a significant factor in the mechanism of the headache or migraine – this a key diagnostic criterion for cervicogenic or neck involvement in headache according to the International Headache Society – importantly for the disorder to be related to the headache or migraine process the headache has to ease as the technique is maintained. If both reproduction and lessening are not possible then the neck may not be
the source of the headache or migraine. Furthermore my experience has shown that if the techniques are performed in a specific manner it is possible to determine which spinal segment is the cause of or contributing significantly to headache and migraine. Having determined which spinal segment (or segments — there may be more than one) is involved then this significantly increases the chance of the treatment being successful because treatment can be directed at specific, relevant spinal segments.

The application of these techniques in Europe, United Kingdom and Australia has become known as the ‘Watson Headache Approach’ and forms the basis of courses I present for physiotherapists, chiropractors and osteopaths in Australia, New Zealand, Hong Kong, Singapore, United Kingdom, Northern Ireland, Belgium, The Netherlands, Switzerland, Germany, Norway and Spain — refer  www.headacheeducation.com The Watson Headache Institute was established to increase the awareness of cervicogenic (neck) disorders in headache and migraine by: imparting my (and that of others) clinical experience and knowledge and, undertaking and supporting rigorous clinical and scientific research in this specialty.

Dean Watson
Consultant Headache and Migraine Physiotherapist; Adjunct Lecturer, Masters Program, School

of Physiotherapy, University of South Australia; PhD Candidate, Murdoch University, Western

Australia