Difficult headaches? Check the neck

The Age, August 30, 2017

With about 800,000 Melburnians mostly aged 25-55 suffering an episode more than once per week, it’s not hard to see why migraine and headache is now the third highest cause of disability in people under 55.

Experts at the recent Migraine World Summit have pointed to a key reason up to 80% of migraine sufferers are looking for a better solution. A key piece of the ‘headache puzzle’ is being overlooked or treated with the wrong techniques.

“It’s essential that we consider the neck very carefully. These (difficult) cases need to be with someone who can treat the neck and put it all together” United States Neurologist Dr Joel Saper of the Michigan Head & Neurological Institute, told the summit.

Roger O’Toole, director at Melbourne Headache Centre, says this message is slowly getting through. “We have an increasing number of specialists and doctors referring difficult to treat cases to us to determine if the neck is playing a role, and in a majority of cases it is, and we can be a significant part of the solution," he says.

Up to 75% of migraine sufferers report neck symptoms before or during episodes, leading many to seek neck based treatments for relief, often with little or no long-term effect. This apparent lack of effect combined with poor results in clinical trials with traditional approaches, has seen the role of the neck demoted to merely a symptom, rather than an important part of the underlying cause of migraine and headache.

Mr O’Toole says this is a mistake.

“The nerves that cause pain in the head mix directly with those nerves coming in from the top part of the neck," he says.

"We know that in chronic headache suffers, regardless of headache type, the area where these nerves mix is in a state of constant over-stimulation. Picture it as a coffee cup that is sitting near full all the time. It doesn’t then take much to ‘trigger’ or spill the cup over the brim. Traditional neck treatments have been designed to treat neck pain and loss of movement, but until now, none has been developed purely to ‘empty the coffee cup’ directly impacting headache and migraine.

An Australian technique known as the Watson Headache Approach has demonstrated clearly 8 that this approach does ‘empty the coffee cup’ by measuring reflex activity relating to the brainstem.

The difference in response is what led Mr O'Toole to open The Melbourne Headache Centre. “I knew this was different and knew that it shouldn’t be confused with traditional techniques. We see people of all ages, with everything from classic migraine and tension-type headache, to cyclical vomiting syndrome, to cluster headache, and we can have a ‘calming effect’ on the brainstem in many cases.”

“We know chronic headache in all its forms is a complex issue, and we can’t help everyone. We endorse Dr Saper’s comments though, and suggest that anyone with chronic, difficult to treat headaches seek an assessment to learn whether an approach, developed specifically to treat the role of the neck in headache may be just the answer you are looking for.” Says Mr. O’Toole

To find out if this approach may be suitable for you fill out the free online assessment today at www.melbourneheadachecentre.com.au