Successful Headache and Migraine Treatment
Several authorities recently summarised the reasons why headache and migraine treatment often fails.
Amongst other factors, they suggested that the diagnosis is incomplete or incorrect and that this could occur for various reasons.
One of the reasons is ‘misdiagnosis’. I have mentioned this research before but diagnosing headache and migraine is like ‘a dog’s breakfast’; it is all over the place with many patients receiving 2 or 3 diagnoses or patients being misdiagnosed – diagnosed as migraine when in fact it was a cervicogenic (neck-related) headache …..!
The medical profession refuses to acknowledge cervicogenic factors – why? Because relating to it does not fit the medical model and anything that does not fit into the medical model is discarded as unworthy of serious consideration.
The entire diagnostic process needs to be reviewed as well as approaches to treatment. Until cervicogenic factors are considered, headache and migraine treatment will remain unsatisfactory with the only option for you, the headache sufferer, being pharmacological management.
Cheers
Dean
(Lipton RB, Silberstein SD, Saper JR, Bigal ME, Goadsby PJ. Why headache treatment fails. Neurology 2003;60:1064-1070
Yi X et al Cervicogenic headache in patients with presumed migraine: missed diagnosis or misdiagnosis? J Pain. 2005 Oct;6(10):700-3)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Optimising Headache and Migraine Treatment
Whilst I was in the UK recently I had the opportunity to meet with several of my accredited practitioners.
I am pleased to say that the results of treatment/feedback from headache and migraine sufferers was amazing. This has increased their (the practitioners’) enthusiasm for a more substantial course (I am already doing two and one day courses).
There was unanimous agreement that it should be a ten day course for small groups of already accredited practitioners. In this course or ‘Master -Class’, the aim would be to examine and treat headache and migraine sufferers on 3-4 occasions, and how to progress from one treatment session to the next.
It was always my aim to develop the best possible teaching model – here it comes! (and it is being driven by practitioners wanting the best possible outcomes for you the headache or migraine sufferer).
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
The Headache and Migraine Sufferers Bill of Rights (cont)
The first ‘bill’ is that the headache sufferer has the right to know his/her headache diagnosis as precisely as possible, and to know the nature of the headache disorder, its prognosis and the possible types of treatment.
I have discussed the first point regarding diagnosis; now
to know the nature of the headache disorder
Clearly there is a substantial body of research which shows that the brainstems of Migraine, Tension Headache and Menstrual Migraine sufferers are sensitised.
We know that the ‘triptans’ desensitise the brainstem and are effective in preventing Migraine, Tension Headache, Cluster Headache, Hemicrania Continua, Menstrual Migraine, Cervicogenic (neck-related) Headache (which shows that cervicogenic disorders can sensitise the brainstem) ……
The underlying disorder is sensitisation of the brainstem; optimal management therefore is identifying the reason for the sensitisation ….
Stay tuned,
Cheers
Dean
(Members’ Handbook. International Headache Society 2000 Scandinavian University Press)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Migraine and Dizziness
Dizziness is a symptom that many headache and migraine sufferers experience
Are migraine and dizziness different presentations of a common disorder?
Some patients of mine have presented with dizziness as their only symptom and whilst they are are grateful they do not have to endure the awful pain of migraine or headache, significant dizziness can be disabling …. and of course dizziness is another symptom that many of my headache and migraine patients experience.
Many of those patients in whom dizziness was as the only symptom have responded to mobilisation of the upper three spinal segments (particularly C2-3 – the segment formed by the second and third vertebrae) – the same segments which have the potential to (and I believe do) sensitise the brainstem in migraine and headache conditions.
So I am not surprised by the recent findings of Japanese researchers which indicates that migraine- associated vertigo (dizziness) and Meniere’s Disease share a common condition.
Just as in migraine (I don’t know why!), the cause of Meniere’s Disease is unknown (and controversial) – could it be that the Meniere’s condition arises from a senstised brainstem?
….. all I know it is worthwhile seeking a skilled examination of your neck!
Cheers
Dean
(Murofushi T, Ozeki H, Inoue A, Sakata A. Does migraine-associated vertigo share a common pathophysiology with Meniere’s disease? Study with vestibular-evoked myogenic potential. Cephalalgia 2009;29:1259-1266)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Watson Headache and Migraine Courses are Presented Internationally
I have been presenting Level I and II courses internationally for over 10 years now. This has included New Zealand, Singapore, Hong Kong, Norway, Spain, Belgium, The Netherlands, Austria, Germany, Switzerland, Ireland and the UK.
I am working on courses in Portugal and Greece in 2010.
Hopefully this means a practitioner close to you!
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Hemicrania Continua and Cluster Headache
One sided headache is likely to respond to neck treatment
Are They Related to Cervicogenic Headache?
A diagnosis of Hemicrania Continua just means you have constant pain on one side of your head (just like Cluster Headache) and shares other similar symptoms with Cluster Headache.
Cervicogenic (neck-related) headache, according to the medical model of headache and migraine, is also a one sided headache.
Research shows that Cluster Headache can be relieved by treating the neck and therefore because of the similarity of Hemicrania Continua to Cluster Headache, Hemicrania Continua.
To review the list of posts related to Hemicrania Continua go to the ‘Home Page’ and you can key in ‘ Hemicrania Continua’.
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Headache and Migraine Definitions
Whilst keeping you informed of the latest research I have used the following terms:
Headache, Migraine, Migraine with aura, Migraine without aura, Tension-type headache, Cluster headache, Paroxysmal Hemicrania, SUNCT, Hemicrania Continua, Cervicogenic headache, Post-Traumatic headache, Menstrual Migraine, Sinus headache, Migraine Episodes, Signs of Pain, Frequency of Pain, Severity of Pain, Symptoms of Pain, Medical Literature, Spinal Segment, Intervertebral Segment, Intervertebral Artery, Triptans, Differential Diagnosis, Abnormal Activity, Brainstem Sensitisation, Headache Continuum, Secondary Headache, Occipital Nerve, Primary Headache, Photophobia, Phonophobia and Osmophobia.
In my experience people who suffer from headache or migraine aree knowledgeable about their pain. However a significant proportion of people suffer in silence and often do not seek treatment or have the resources to do so.
Should you have any questions or comments that you wish to pose or make about any of the terms used please do so.
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
The Advanced Level II Watson Headache and Migraine Courses
After delegates have completed the Level I course and at least 6 months experience using the approach, they can then apply to participate in the Level II Advanced course titled:
“The Role of CO-C3 Segmental Dysfunction in Primary Headache – Level II”
or the less formal title
“OK – so I have found the segments involved – what next?”
This is a one day course at which delegates have the opportunity to raise questions or discuss issues they have had in the previous 6 months. We also revise the examination techniques and discuss their use more as treatment techniques. I also examine a headache or migraine sufferer.
These days are very intensive and often go on beyond the scheduled conclusion time because the delegates are excited about the difference they have made to their headache and migraine patients!
I have now been approached to organise longer courses ….. more of that later!
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Do You Experience Headache or Migraine?
Do you have a question or a comment you would like to make about headache or migraine?
If you do experience headache or migraine and you have a question that you would like answered or would like to comment on your headache or migraine experience then please feel free to post it below.
Whilst it may not be possible to address all questions or comments these will be addressed in future posts in some way.
It is our aim to help all headache or migraine sufferers to know and understand their headache or migraine experience as clearly and as precisely as possible .
Cheers Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Headache and Migraine Courses in Sydney
Headache and Migraine Courses, Sydney
You may be wondering what happens to headache and migraine sufferers in Australia!
Like Cambridge I have been presenting regularly in Sydney (usually twice a year) and have just completed another successful fully subscribed Level II course in Sydney – which like Cambridge attracts physiotherapists from around the country.
However Australia is a large country so it is time to take the courses to Brisbane, Melbourne, Hobart and Perth once again – a busy 2010!
Cheers Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved