Letter From Dean Watson PhD
Hello I am Dean Watson Director of the Watson Headache® Institute.
I’m a titled musculoskeletal physiotherapist and have completed my research doctorate in which I investigated the role of the upper cervical afferents in migraine. I have consulted those suffering headache and migraine exclusively for 26 years – in this time I have amassed unparalleled experience treating headache and migraine exclusively – 22, 000 hours with 8, 000 patients – I have come to recognize that upper cervical dysfunction is significantly underestimated in primary headache i.e., tension headache, migraine and the trigeminal autonomic cephalalgias, in fact headache and migraine generally…
This clinical experience has evolved into the WatsonHeadache® Approach which I have now taught nationally and internationally for the past 20 years. My courses are primarily for those in the manual therapy professions but also include medical doctors who have additional qualifications in the musculoskeletal area.
The biggest problem is the perspective of the medical model of headache (and consequently what we are taught) i.e., that cervical dysfunction cannot be a causal factor in primary headache – so our beliefs get in the way i.e., as manual therapists we can only treat cervicogenic headache – this defies elementary neuro anatomy and shows the ignorance of the medical model of headache.
Secondly, how many of us as new graduates had comprehensive knowledge of and were confident palpating the upper cervical spine, and please, please…. do not ask me to assess the stability of the upper cervical spine – stability testing is not even taught in undergraduate programs anymore! So without these skills what chance do we have of not only finding and determining the relevancy of upper cervical dysfunction to primary headache, let alone managing it successfully? How likely then is it that we are going to be successful(?) and then what happens? ‘Yellow Flags’ or ‘central sensitisation’ or ‘chronicity’ are blamed. This is a disservice to those afflicted by headache and migraine.
We need to think critically and take a hard, long look at ourselves and recognize that maybe, just maybe… unsuccessful outcomes are a result of OUR lack of skill (as manual therapists) and misconceptions. Once you start consulting those with headache and migraine with advanced skills, and a liberal, common sense perspective, outcomes will change and your paradigm will shift enormously.
So, if you believe that we can only treat cervicogenic headache you are not up-to-date with contemporary research you are accepting what you have been taught at face value. You are neglecting a very, very large group of patients. Headache and migraine is one of the most, if not, the most common ailment known to humankind.
- are dissatisfied with poor outcomes with your headache patients,
- need clarity and direction
- are not confident assessing and treating the upper cervical spine,
- Then download my complimentary guide “10 Misconceptions When Treating Headache and Migraine” which will give you my insights based on 22000 hours of experience.
Developing advanced skills in treating headache and migraine means superior outcomes for your patients. You know what this means. You will be run off your feet and your general clinic will quickly be transformed into a headache clinic!
So, I invite you to download the complimentary guide (pdf) and I will explain…
- how the answer to one question will tell you without doubt if the origin headache or migraine lies within the upper cervical spine
- why the assumption that cervical afferents are not involved in primary headache is false
- why chronicity of headache or migraine does not imply immediate or expeditious relief
- why ‘complex’ presentations do not necessarily require a multi-disciplinary approach
- why focusing on ‘Yellow Flags’ initially is exactly what we should not be doing – watch them disappear when symptoms improve!
- why reproduction of headache when examining upper cervical structures is not the definitive indication of cervical involvement in headache or migraine
- why the belief that reproduction of headache when examining the upper cervical structures is inappropriate… is to be avoided, is wrong… it is crucial!
- why the belief that reversing ‘chronic’ central sensitisation is a slow process is erroneous (at least in chronic headache and migraine)
- why the C1-2 segment is not commonly involved in headache or migraine
- why the assumption that cervicogenic headache is side-locked i.e., it does not alternate or swap sides is incorrect, in fact alternating headache or headache with side-shift IS a cervicogenic headache.
Thank you for listening, I’m Dean Watson and I look forward to working with you.
PhD; MAppSc(Res); GradDipAdvManipTher; International Educator & Mentor & Consultant; Headache & Migraine Physiotherapist; Director, Watson Headache® Clinic & Watson Headache® Institute; Adjunct Lecturer, Masters Program, Physiotherapy School, University of South Australia
P.S. Join me and the Watson Headache® Institute’s mission …
… that every person experiencing headache or migraine routinely has access to a skilful assessment of the upper cervical spine.