Exercise, Serotonin, Headache and Migraine

June 30, 2009 by dean · Leave a Comment 

Reducing migraine, intensity of and need for medication with exercise

Reducing migraine and the need for medication with regular activity

Recent research from Sweden, published in Headache: The Journal of Head and Face Pain, states regular activity can reduce the number of migraines, the intensity of migraines and the need for pain medication.

This supports Norwegian research which found that people who don’t exercise are 14 percent more likely to experience headache.

Why is it that these findings are met with surprise in some circles? This is not rocket science! The Brainstems in migraine sufferers are sensitised and exercise increases the production of serotonin. Serotinin desensitises the brainstem.

However some headache and migraine sufferers avoid exercise because it may trigger an attack – the challenge is to find a form of exercise which does not …. stay tuned!

Cheers

Dean

(Katsavara Z, Giffin N, Diener HC, Kaube H. Abnormal habituation of ‘nociceptive’ blink reflex in migraine – evidence for increased excitability of trigeminal nociception. Cephalalgia 2003; 23:814-819

Katsavara Z, Lehnerdt G, Duda B, Ellrich J, Diener HC, Kaube H. Sensitization of trigeminal nociception specific for migraine but not pain of sinusitis. Neurology 2002; 59:1450-1453

Kaube H, Katasavara Z, Przywara S, Drepper J, Ellrich J, Diener HC. Acute migraine headache. Possible sensitization of neurons in the spinal trigeminal nucleus? Neurology 2002; 58:1234-1238

Koseoglu E, Akboyraz A, Soyuer A, Ersoy AO. Aerobic exercise and plasma beta endorphin levels in patients with migrainous headache without aura. Cephalalgia 2003; 23:972–6.

Kumar KK. Exercise for prophylaxis of migraine. Headache 1988; 28:228)

Lockett DM, Campbell JF. The effects of aerobic exercise on migraine. Headache 1992; 32:50–4.

Narin SO, Pinar L, Erbas D, Ozturk V, Idiman F. The effects of exercise and exercise-related changes in blood nitric oxide level on migraine headache. Clin Rehabil 2003; 17:624–30.

Sandrini G, Cecchini AB, Milanov I, Tassorelli C, Buzzi MG, Nappi G. Electrophysiological evidence for trigeminal neuron sensitisation in patients with migraine. Neurosci Lett 2002; 317:135-138

Varkey E, Cider A,Carlsson J, Linde M. Study to Evaluate the Feasibility of an Aerobic Exercise Program in Patients With Migraine. Headache 2009;49:563-570

Varkey E, Hagen K, Zwart J-A & Linde M. Physical activity and headache: results from the Nord-Trøndelag Health Study (HUNT). Cephalalgia 2008; 28:1292–1297.)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Headache and Migraine Treatment and the ‘Watson Headache Approach’

June 28, 2009 by dean · Leave a Comment 

Further to the article in ‘Frontline’ and in reference to the approach I have developed it is important to clarify that whilst my approach does include a series of techniques which restore movement and maintain natural posture of the upper cervical spine, and whilst they are powerful, they are a small part of what I have developed.

My clinical experience of over 21000 hours with headache and migraine sufferers has demonstrated that neck disorders, as the cause of sensitisation, are significantly underestimated in migraine, tension and cluster headache, menstrual migraine…. sufferers.

There are many ways to treating headache and migraine.  My approach is a powerful treatment tool if chosen by Practitioners. What I am primarily passionate about is that many of you are suffering unnecessarily because your necks have not been examined comprehensively and this is the main thrust of my approach.

It is about identifying whether your neck is the source of your headache or migraine before you commence treatment.

How much longer are we to accept the explanation that … “whilst we don’t know where migraine comes from it can’t come from neck disorders” … it is irresponsible, after other investigations have ruled out other causes, for the neck not to be examined. Information from the neck is one of four systems that has the potential to potential to sensitise the brainstem – the feature (sensitisation) that is evident in the common forms of headache and migraine.

Cheers

Dean

(Hunt L. When headache is a pain in the neck. Frontline 2009 17 June; 22-25)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Does Your Headache or Migraine Swap Sides?

June 17, 2009 by dean · Leave a Comment 

If headache/migraine swaps sides it is a neck headache

If headache/migraine swaps sides it is a neck headache

The traditional medical model of headache and migraine, describes one of the key diagnostic criteria for cervicogenic headache as being a side-locked headache – which means that it is always on the same side – never on the other.

I have news for you. Based on over 13000 hours clinical experience with headache and migraine sufferers, I can confidently say that if your headache or migraine swaps sides between attacks, or within the same attack, it is a cervicogenic headache! … and the problem lies with the C2-3 spinal segment.

Cheers  Dean

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Welcome Headache and Migraine Sufferers

June 9, 2009 by dean · Leave a Comment 

In 1991 I embarked on a path that was to become the greatest challenge of my life, establishing The Headache Clinic, www.headacheclinic.com.au, in Adelaide, South Australia, in 1991.   The fundamental purpose of The Headache Clinic was and is determining whether or not a neck (cervicogenic) disorder is the cause of or a significant contributing factor to headache or migraine.

We are the sum of our experiences — and my unparalleled clinical experience (having consulted over 7000 headache and migraine patients – in excess of 28000 treatments – with a range of diagnoses) suggests that neck (cervicogenic) dysfunction is significantly underestimated and can be the cause of various forms of headache and migraine. I believe therefore, that, in the presence of negative medical tests, the necks of all (primary) headache and migraine sufferers should be examined, irrespective of the diagnosis. Whilst this challenges traditionally held medical beliefs, it is incumbent to not only pass on this experience to my colleagues and headache and migraine sufferers, but to support this experience with rigorous scientific research (I am currently a PhD Candidate investigating the role of cervicogenic dysfunction in the mechanism of migraine at Murdoch University, Western Australia).

It is irresponsible to treat irrelevant cervicogenic (neck) dysfunction in migraine and headache conditions.  However given that the causes of migraine and tension headache are not clear, the advances in our knowledge of pain mechanisms and the not insignificant body research supporting cervicogenic factors as key players in the headache and migraine processes, it is also irresponsible not to examine the necks of headache sufferers irrespective of the diagnosis. How much longer do we accept the notion that ‘whilst we do not know what causes migraine it can’t come from the neck’?

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 and www.headacheandmigraine.com for International Practioner Directory.

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

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Practitioners

June 5, 2009 by dean · Leave a Comment 

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. Because treatment of the 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.

This directory aims to provide headache and migraine sufferers with 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.  Be assured that if, on examination, no relevant disorders can be found, treatment will not be recommended.  Relevancy is determined by temporary reproduction and lessening of headache as the examination technique is sustained.

Cheers

Dean

(Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004; 24(suppl.1):1-151

Sjaastad O, Fredricksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache 1998; 38:442-5)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Headache and Migraine Education

June 3, 2009 by dean · Leave a Comment 

Up to date knowledge is self empowering

Appropriate up to date knowledge is self empowering

Appropriate and up-to-date knowledge is self-empowering; I believe that every headache and migraine sufferer has the right to know their headache and migraine 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 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. ‘Headache and Migraine Education’ is one of the aims of Watson Headache Institute – it is here that relevant, past and present research will be summarised and discussed…

Cheers  Dean

(Afridi SK, Shields KG, Bhola R, Goadsby PJ. Greater occipital nerve injection in primary headache syndromes – prolonged effects from a single injection. Pain 2006; 122:126-9)

Anderson CD, Franks RA. Migraine and tension headache: is there a physiological difference? Headache 1981; 21:63-71

Cady R, Schreiber C, Farmer K, Sheftell F. Primary headaches: a convergence hypothesis. Headache 2002; 42:204-16

Featherstone HJ. Migraine and muscle contraction headaches: a continuum. Headache 1985; 25:194-198

Featherstone HJ. Migraine and muscle contraction headaches: a continuum. Headache 1985; 25:194-8

Marcus D, Scharff L, Mercer S, Turk D. Musculoskeletal abnormalities in chronic headache: a controlled comparison of headache diagnostic groups. Headache 1999; 39:21-27

Mercer S, Marcus DA, Nash J. Cervical musculoskeletal disorders in migraine and tension-type headache. Paper presented at the 68th Annual Meeting of the American Physical Therapy Association; 1993; Cincinatti, Ohio

Marcus DA. Migraine and tension-type headaches: the questionable validity of current classification systems. Clin J Pain 1992; 8:28-36

Nelson CF. The tension headache, migraine headache continuum: A hypothesis J Manipulative Physiol Ther 1994; 17:156-167

Vernon H, Steiman I, Hagino C. Cervicogenic dysfunction in muscle contraction headache and migraine: A descriptive study. J Manipulative Physiol Ther 1992; 15:418-429)

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.

Introducing the Watson Headache Institute

June 1, 2009 by dean · Leave a Comment 

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.We are the sum of our experiences — and my unparalleled clinical experience (having consulted over 7000 headache and migraine patients – in excess of 28000 treatments – with a range of diagnoses) suggests that neck (cervicogenic) dysfunction is significantly underestimated and can be the cause of various forms of headache and migraine. I believe therefore, that, in the presence of negative medical tests, the necks of all (primary) headache and migraine sufferers should be examined, irrespective of the diagnosis. Whilst this challenges traditionally held medical beliefs, it is incumbent to not only pass on this experience to my colleagues and headache and migraine sufferers, but to support this experience with rigorous scientific research (I am currently a PhD Candidate investigating the role of cervicogenic dysfunction in the mechanism of migraine at Murdoch University, Western Australia).

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 as well as undertaking and supporting rigorous clinical and scientific research in this speciality.

© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.