The list of differential diagnosis for headache and migraines are the longest in the medical world. Whilst many headache disorders exist, the medical classification model in headache divides headache in 2 main categories:

  1. tension type headache
  2. migraine

New research on headache has shown that current headaches and migraines (where all scans and MRI are inconclusive) in most cases are caused by a sensitized brainstem.

Triptans, maybe more familiar to you as effective medications such as Imigran, Maxalt or Zomig, are designed to desentize the brainstem, however this effect is only temporary.

The Brainstem

The brainstem (trigemino cervical nucleus) is a control centre in the brain receiving information from among others, the following structures (neck, head, face, blood vessels in the brain) and then passes it on to the cortex (large brain). If the brainstem is sensitized then this information is what "normal" information is, is inflated and if this info then reaches the cortex, this is interpreted as a threat. The cortex raises alarm to the body by creating pain and in this case head pain. You should see the brainstem as an audio speaker with the volume turned up to high.


What causes sensitisation of the brainstem and can the
International Headache Clinic help you?

internationale hoofdpijnkliniek

All the information that is filtered through the nucleus will be
over exaggerated (just like an audio speaker with the volume
turned up to high). As it reaches the cortex this information is
interpreted by the cortex as danger, and it will then raise the
alarm to the body and create pain and in this case head pain.


There are 4 potential causes for sensitising the brainstem:

  1. Abnormal information from structures of the head (serious conditions such as tumor or inflammation processes in the jaw or tooth) can bring up the volume of the audio speaker (brainstem)
  2. Abnormal information from structures of the upper cervical spine (such as ligaments, joints or disc of the C2,3 segment) also affects the volume of the audio speaker (brainstem).
  3. Inadequate serotonin levels in the blood(chemical that regulates the response to stress, food and hormones).
  4. An error in the supraspinal pain inhibitory system (DNIC). This also affects the volume in the audio speaker (brainstem). This systems works, for example, as you hit your thump with a hammer, making your headache less severe.

All of the 4 above mentioned information sources are normally filtered by the brainstem before they are transported to the cortex (they have a normal function and activity level and are symptom free).

Treating the high cervical spine using the Watson Headache® Approach has scientificallly been proven to be effective in desensitising the brainstem. Temporary reproduction and reduction of your headache has an effect on desensitisation of the brainstem. Exactly the same effect triptans have on your headache/migraine, but rather than a temporary effect provides a long lasting solution for your headache/migraine condition!!!

In general, people often report that their headache/migraines are related to the following triggers:

  • stress
  • fatigue
  • menstrual cycle
  • posture
  • food (chocolate, red wine)
  • dehydration

The question that should be asked is “Why do people get headaches related to stress or menstrual cycle?”

Not every woman gets a migraine during menstrual cycle and not everyone gets stress related headaches. The answer lies in the brainstem. Recent research indicates that a sensitized nucleus underlies the emergence of headache and migraine.

Depending on the degree of sensitisation the brainstem will reproduce headache or migraine (less to more severe pain response). The headache and migraine patient his brainstem has become sensitive to changes from its environment from input from neck, blood vessels or serotonin levels.
A non migraine patient is able to cope with these changes in a normal way without causing headache/migraine. That is the difference.

How can we judge whether your neck is causing your headache/migraine?

For instance if your headache is on 2 sides of the head or within one headache attack, your headache moves from left to right or visa versa. If your headache is on the left side of your head one time and on the right side of your head the next then there is a strong indication that the neck has a prominent role in the cause of your headache/migraine.
Also if we can temporarily reproduce and reduce your recognisable headache during examination if the technique is performed in a sustained manner, this also confirms the role of the neck in your headache/migraine condition.

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