Why Assessing the Upper Neck is so important with Headaches and Migraines

We hear stories from patients all the time about failed techniques and strategies to try to deal with headache and migraine.  Things like trigger avoidance, drinking more water and taking stronger and stronger medication may not work, especially when there is a hidden cause that hasn’t been assessed.

When having headache and migraine assessed, it is vitally important that the upper cervical spine is assessed, and assessed properly.  It is now common knowledge that there is a common pathway that links the sensory nerves for your upper neck, jaw, face, and the blood vessels in your brain.  This is extremely important, and very often forgotten, when medical professionals are assessing how headaches and migraines are beginning.

Treating headache and migraine without assessing the neck is like treating chest pain without a stethoscope – the symptoms are all there, you can predict what it may be, but you’re not assessing it fully.  Without a full assessment, you cannot have the best diagnosis, and therefore not the most accurate and specific treatment plan. 

But that’s not all – the assessment of the neck must be carried out by someone who is acutely aware of how the neck moves, and how much movement a person can tolerate without making things worse.  It is commonly reported to us that patients have had their neck assessed and treated – “but it made things worse”.  The reason why things get worse, is usually because either the assessment was too much for the person’s system to handle (ie they have been pushed too hard), or that the assessment was carried out in the wrong direction (ie. They are pushing on the left rather than pushing on the right). 

The biggest mistake that health professionals make when considering headache and migraine is to neglect the upper neck in the assessment process – and the best way to assess the neck is to do things carefully and specifically.  The approach that our clinic uses is called the Watson Headache Approach, developed by South Australian Dr Dean Watson.  It is a systemised process which determines which joint is affected, and in which direction.  When this is carried out correctly, then diagnosing which joint is affected becomes quite straightforward.

All of the staff at The Headache and Pain Management Centre treat headache and migraine every single day, and have seen literally thousands of cases between them – including:

  • Migraine with Aura
  • Migraine without Aura
  • Tension Headache
  • Cluster Headache
  • Hormonal Headache
  • Trigeminal Neuralgia
  • Vestibular Headache/Migraine….

And many other rarer conditions.

The Watson Headache Approach, and the other assessment methods that we employ, give a very strong chance of diagnosing if the neck is involved or not.  If the neck is involved, then treatment begins immediately, with every step of the process explained in clear language on Day One, should you go ahead with treatment.

By Chris Fawcett - Director, The Headache and Pain Management Centre

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