Welcome to The Headache Clinic
As a migraine or headache sufferer, you will know how disruptive and inconvenient a migraine attack or headache can be - not only does it impact on you but also your immediate family and friends who watch on helplessly.
I established The Headache Clinic in Adelaide in 1991 to provide skilled and advanced assessment of the neck as a possible source of headache. My fundamental purpose was and is identifying upper neck disorders and their relevancy to the headache and migraine process.
However the role of the neck in headache and migraine has been underestimated and recent and ongoing research (along with my clinical experience) has demonstrated that disorders in the neck have the potential to cause migraine and other forms of headache.
Furthermore given that the cause of migraine and other forms of headache is unknown, it seems logical and reasonable that a skilled examination of your neck occurs after an assessment by your GP or a Neurologist and before medication is prescribed.
It is appropriate that the first step is for your headache or migraine to be assessed by your GP who will then determine if a neurological opinion is required and whether a scan of your head is necessary.
In the vast majority of cases a scan is negative, that is, no abnormality is present.
Similarly if your headache or migraine has been present for years and your neck has not been examined then an examination would be appropriate for in my experience a neck disorder is likely to be responsible.
Staff at The Headache Clinic will not only explain the role disorders of the neck can have in the headache and migraine process but also undertake a skilled and responsible assessment of your headache or migraine. This involves taking a detailed history, mapping out the area of headache and analysing the behavior of symptoms. This is followed by a physical examination of your neck, which includes, but is not necessarily confined to, assessment of the movement of the upper three spinal segments or joints.
One of the key diagnostic features of neck involvement in headache is the temporary reproduction of headache.
However it is important to recognise that reproduction of headache alone is not enough to confirm that the disorder is the cause of headache or migraine.
Since 1991 I have developed a series of techniques, which, by way of temporary reproduction of headache (symptoms) and easing of the headache as a technique is sustained, confirm that a neck disorder is a significant factor in the cause of the headache or migraine. 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 or migraine. If it is possible to determine which spinal segment (or segments – there may be more than one) is involved then this significantly increases the chance of the treatment being successful.
From this examination we are able to provide advice and reassurance and prescribe the treatment most advantageous and acceptable to you according to current knowledge.
If on examination there are no relevant disorders to be found in your neck or upper back, treatment cannot be justified and would not be recommended. In this case we would liaise with your GP if further investigation were required.
If treatment is justified it usually comprises passive (efforts/or not under your control) movement techniques. These are applied in a smooth rhythmic or sustained fashion to gradually stretch shortened (spinal) segmental structures (capsules, ligaments and muscles). It is a 'persuasive' type of treatment aimed at restoring function in each of the normal movement directions ensuring that the movements are free without restriction. These small movements are necessary for the joints to function normally.
To maintain healthy function of spinal segments it may be that exercises to stretch and strengthen muscles need to be performed, along with alteration in posture.
Treatment using the 'Watson Headache Approach' does not involve manipulation or 'cracking' of the neck.
At The Headache Clinic we expect appreciable improvement within five treatments and if this has not occurred then it is unlikely further treatment will be successful. To justify ongoing treatment there needs to be identifiable, positive changes in your headache or migraine symptoms.
Rest assured that we would do our best to effect improvement and/or resolution of your headache or migraine symptoms.
Good Luck!
Dean Watson
Master of Applied Science (Manip Ther - by Research)
PhD Candidate, Murdoch University, WA
Consultant Headache and Migraine Physiotherapist
International Lecturer
