Dean Anderson
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Dean Anderson

If You Hate Getting Headache Read This Now!
So You Have Been Given A Diagnosis – Has This Been Helpful To You?
I suspect not, for diagnosis is based on a set of signs and symptoms – a diagnosis does not give you any information as to what is causing your headache or migraine.
The diagnosis you have been given is based on the International Headache Society’s classification system. However, because consistent research is lacking and evidence for assumptions is inadequate, a large part of the diagnostic classification system is based on expert opinion and compromise; the system is subject to criticism and frequently challenged. The authors of the classification system have acknowledged this, indicating that the system is unwieldy, lengthy and very detailed and that it was essentially intended for research rather than as a clinical tool. This is not assisted by the fact that there are overlapping symptoms between cervicogenic (neck-related) headache, tension-type headache and migraine (making differential diagnosis unconvincing), and increasing evidence which suggests that the different headache types share a common mechanism – perhaps the different headache and migraine types are not separate entities, but simply different expressions of the same process.
It is interesting to note that the ‘triptans’ (medication designed specifically to abort the migraine process) are effective in managing migraine, tension-type headache, menstrual migraine, cluster headache, sinus headache, cervicogenic and post-traumatic (whiplash) headache – Why? Supposedly the ‘triptans’ stop the migraine by constricting or narrowing the blood vessels … but are menstrual migraine, tension headache and sinus headache, for example, caused by expanding blood vessels?
Other questions are intriguing also …
Why is it that whiplash-associated headaches exhibit similar features to migraine, tension-type and cervicogenic headache?
Why is it that accompanying neck pain and or stiffness, and headache or migraine triggered by neck position or movement, which are distinctive features of cervicogenic headache, and a history of migraine, tension headache, menstrual migraine, cluster headache start soon after neck trauma?
Why is it that many women not only endure menstrual migraine but also experience similar headaches at other times in their cycle, when oestrogen levels are not significantly lowered – for example mid cycle when oestrogen is at its highest? Menstrual migraine supposedly results from decreased eostrogen …
The answers can be drawn from the recent and significant research, which has demonstrated that the brainstem is sensitised or hyper-excitable in both migraine and tension-type headache sufferers and that the ‘triptans’ desensitise the brainstem (suggesting that sensitisation is evident in range of headache and migraine conditions – and the upper cervical spine (neck) is in a key position to sensitise the brainstem).
It is appropriate that the first step is for your headache or migraine to be assessed by your doctor 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. Subsequently, what usually happens is that medication is suggested, and then starts a ‘merry-go-round’ of trying different medication regimes; you as headache or migraine sufferer are (perhaps unnecessarily) destined to a lifetime of medication.
At this point, what is missing is a thorough examination of the structures of the upper neck.
Why is it that the role of the cervicogenic (neck-related) factors in headache and migraine, is largely dismissed by the medical model of headache? Perhaps it is because consideration of the neck does not fit the medical model and anything that does not fit into the medical model is not given serious consideration. Furthermore, because examination of the neck does not fit into the medical model, there has been little interest in developing the role of treating the neck for the relief of headache or migraine. Given the significant number of people who suffer headache and migraine it is essential that all factors that could sensitise the brainstem be investigated equally (this is not the case with the cervicogenic aspect) to create a more comprehensive approach.
As a result of my unparalleled clinical experience I have developed an approach, which not only determines if disorders of your neck are likely to be the source of your headache symptoms (sensitisation), but can also identify the spinal segments at fault. This diagnostic accuracy increases the chances of a successful outcome.
I know that some of you may have had your necks examined and treated unsuccessfully but until your neck has been examined by a practitioner* experienced in this approach, your upper neck cannot be ruled out as the source of your headache or migraine – what is it to be – the possibility that your neck has been the unidentified source all along or a lifetime of ongoing medication?
Hint: If your headache or migraine is one sided and then on another occasion is on the other side, or if your headache can swap sides within the same episode the source of your headache is your neck and it is the C(cervical) 2-3 spinal segment!
Dean
Dean H Watson
Consultant Headache & Migraine Physiotherapist; International Teacher; Director, The Headache Clinic & Watson Headache Institute; PhD Candidate Murdoch University, Western Australia; Adjunct Lecturer, Masters Program, Physiotherapy School, University of South Australia; MAppSc(Res) GradDipAdvManipTher
Experienced health practitioners trained in the Watson Headache Approach perform the examination and treatment techniques developed by Dean Watson. These techniques are based on his extensive experience of 7000 headache patients (21,000 hours) over 21 years and are now taught internationally.
For your nearest practitioner who has completed training in the ‘Watson Headache Approach’ please refer to the ‘Practitioner Directory’.
(Anderson CD, Franks RA. Migraine and tension headache: is there a physiological difference? Headache 1981; 21:63-71
Brennum J, Kjeldsen M, Olesen J. The 5-HT1-like agonist sumatriptan has a signiicant effect in chronic tension-type headache. Cephalalgia 1992;12(6):375-379
Cady RK, Gutterman D, Saires JA, Beach ME. Responsiveness of non-IHS migraine and tesnion-type headache to sumatrptan. Cephalalgia 1997;17:588-90
Cady RK, Gutterman D, Saires JA, Beach ME. Responsiveness of non-IHS migraine and tesnion-type headache to sumatrptan. Cephalalgia 1997;17:588-90
Cady R, Schreiber C, Farmer K, Sheftell F. Primary headaches: a convergence hypothesis. Headache 2002; 42:204-16
Classification and diagnostic criteria for headache disorders, cranial neuralgias and facila pain. Headache Classification Committee of the International Headache Society. Cephalalgia. 1988;8 Suppl 7:1-96
De Benedittis G, De Santis A. Chronic post-traumatic headache: clinical, psychopathological features and outcome determinants. J Neurosug Sci 1983;27(3):177-186
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
Göbel H. Classification of headaches. Cephalalgia 2001;21(7):770-3
Haas DC. Chronic post-traumatic headaches classified and compared with natural headaches. Cephalalgia 1996;16:486-93
Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004; 24(suppl.1):1-151
Hoskin KL, Kaube H, Goadsby PJ. Sumatriptan can inhibit trigeminal afferents by an exclusively neural mechanism. Brain1996; 119:1419-28
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
Kari E, DelGaudio JM. Treatment of sinus headache as migraine: the diagnostic utility of triptans. Laryngoscope 2008 Dec;118(12) :2235-9
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
Kim H. The characteristics of sinus headache resembling the primary headaches. Nippon Rinsho 2005 Oct;63(10):1771-6
Leone M, D’Amico D, Grazzi L, Attanasio A, Bussone G. Cervicogenic headache: a critical review of the current diagnostic criteria. Pain. 1998 Oct;78(1):1-5.
Lipton RB, Walter FS, Cady R, Hall C, O’Quinn S, Kuhn T, Gutterman D. Sumatriptan for the Range of Headaches in Migraine Sufferers: Results of the Spectrum Study. Headache 2000;40(10);783-791
Mannix LK, Files JA. The use of triptans in the management of menstrual migraine. CNS Drugs 2005;19(11): 951-72
Marcus DA. Migraine and tension-type headaches: the questionable validity of current classification systems. Clin J Pain 1992; 8:28-36
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
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Nardone R et al Trigemino-Cervical Reflex Abnormalities in Patients with Migraine and Cluster Headache. Headache 2008; 48(4):578-585
Nelson CF. The tension headache, migraine headache continuum: A hypothesis J Manipulative Physiol Ther 1994; 17:156-167
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The information on this website is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Reading this article signifies your acceptance and understanding of the Terms and Conditions of YourHeadacheSolutions.co.uk.
About the Author
Dean Watson of YourHeadache Solutions, Consultant Headache and Migraine Physiotherapist; Adjunct Lecturer, Masters Program, School of Physiotherapy, University of South Australia; PhD Candidate, Murdoch University, Western Australia. On his site you can search all topics about headache migraine, headache treatment, migraine treatment, headache causes, migraine causes headache symptoms and more.
I have always loved watching the series "MACGYVER". Its like I adore Richard Dean Anderson . How many of you..
..liked / loved watching MacGyver ?? I used to watch it over Bangladesh TV when I was just a teenager. Now after more than 20 yrs I don't get to see it over any of the numerous televison channels here in India. I wish they would show it all over again. I never saw Stargate though. My Australian penfriend Adriana loves R.D. Anderson too.
Hello and welcome to the MCGYVER-fans world!!
You are right that once upon a time the famous Richard Dean Anderson stole the heart and mind of the people of Bangladesh who would watch the weekly episode religiously!
In those good old days when there were only BTV (Bangladesh Television) reigning the wavelengths in Bangladesh we used to enjoy each and every weekly shows and dramas etc.
Now with the advent of satellite TV channels in Bangladesh and the continuous onslaught of Indian soap-operas we have lost the touch of having watched same movies or serials at the same time and discuss with awe what we have seen on the next day's meeting!! (Socialism in practice - lol).
I just hope that our new generations would get to see such thrilling and inspiring shows which may mould their character a bit and make them more self-confident in facing the real world with limited resources.
Happy New Year and Eid Mubarak!
Richard Dean Anderson I'm sorry




































































































