Evidence Supporting the Watson Headache Approach

Manual cervical therapy and vestibular migraine: A case series

O’Toole, R., & Watson, D. (2023). Manual cervical therapy and vestibular migraine: A case series. Health Open Research, 5, 12.

 

While a case series and not a randomized controlled trial, this important piece of recent research identified rapid, observable and sustained improvement in Vestibular Migraineurs following manual cervical therapy using the Watson Headache® Approach. It illustrates effectiveness of the approach in the treatment of patients with Vestibular Migraine (VM).

 

Musculoskeletal dysfunction in migraine patients

Luedtke, K., Starke, W., & May, A. (2018). Musculoskeletal dysfunction in migraine patients. Cephalalgia, 38(5), 865–875

 

In this follow-up research to the 2016 Delphi study cited below, six of the eleven tests that had been identified by a panel of manual therapist experts as being important to confirm the role of the upper cervical spine in headache were used in migraine patients. 93% of migraine sufferers tested positive on at least three out of six tests. Reproduction and resolution of familiar head pain as used in the Watson Headache® Approach was one of those final six tests.

 

Assessing the feasibility of mobilisation of C0-C3 cervical segments to reduce headache in migraineurs

Davidson, I., Crooks, K., Newington, L., Pilling, M., & Todd, C. (2018). Assessing the feasibility of mobilisation of C0-C3 cervical segments to reduce headache in migraineurs. International Journal of Therapy and Rehabilitation, 25(8), 382–394

 

This study was able to identify a positive trend in outcome measures used to assess treatment efficacy, including reduction in headache days, headache duration, reduction in migraine hours, reduction in medication use over time, with the improvement in outcome measures sustained after the three-month follow-up. This was particularly relevant as the therapists undertaking treatment of participants were both inexperienced in the Watson Headache® Approach and used an artificial thumb to execute the techniques.

 

Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine

Luedtke, K., & May, A. (2017). Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine. The Journal of Headache and Pain, 18(1), 97–97. https://doi.org/10.1186/s10194-017-0808-0

 

Neck pain is highly prevalent in migraineurs, either preceding or during an episode. It is thought that neck pain is not only a symptom of migraine but, rather, corresponds to identifiable muscle and joint mechanical issues. Palpation of the upper cervical spine using the Watson Headache® Approach’s reproduction and resolution, in addition to local elicited pain at the site, was able to identify 89% of migraineurs from the 179 migraineurs examined in this study.

 

International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study

Luedtke et al (2016). International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study. Manual Therapy, 23, 17–24

 

An international panel of 17 experts considered experts in the role of the upper cervical spine and headache, selected the Watson Headache® Approach's key tenet of reproduction and resolution of familiar head pain as one of the eleven most important tests to confirm the role of the upper cervical spine in headache.

 

The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study

Watson, D. H., & Drummond, P. D. (2016). The Role of the Trigemino Cervical Complex in Chronic Whiplash Associated Headache: A Cross Sectional Study. Headache, 56(6), 961–975. https://doi.org/10.1111/head.12805

 

People with Chronic Whiplash-Associated Headache (CWAH) often present with symptoms that look like a primary headache disorder. Typically, this includes migraine (increased light sensitivity and increased pain sensitivity) or tension-type headache (TTH). Exclusion of other diagnosis is a key pillar of the international headache society (IHS) diagnostic criteria. As such, a thorough, skilled assessment of the cervical spine should be undertaken so that neck-related causes are properly considered before a primary headache diagnosis is confirmed.

 

Cervical referral of head pain in migraineurs: Effects on the nociceptive blink reflex

Watson, D. H., & Drummond, P. D. (2014). Cervical referral of head pain in migraineurs: Effects on the nociceptive blink reflex. Headache, 54(6), 1035–1045

 

This research suggests that manual therapy can help normalise the nociceptive blink reflex, which is a brainstem-mediated reflex that is often altered in people with primary headache. It supports the idea that the Watson Headache® Approach can reduce brainstem sensitivity using gentle, targeted hands-on techniques.

 

Head pain referral during examination of the neck in migraine and tension-type headache

Watson, D. H., & Drummond, P. D. (2012). Head pain referral during examination of the neck in migraine and tension-type headache. Headache, 52(8), 1226–1235

 

Reproduction and resolution of a patient’s usual head pain, amongst other principles, provides the foundation of the Watson Headache ® Approach developed by Dean Watson. This article provides the basis for demonstrating how input from the neck (peripheral inputs) via a manual therapy technique can contribute to and alter sensitisation of the Trigeminocervical complex (TCN), a form of central sensitisation.