"My neck isn't involved - I don't get a sore neck. I know my migraines come from stress/eating chocolate/drinking red wine."
What of these triggers? Is it an allergy? How can it be your neck if you eat something and get a migraine?
There are many different triggers for chronic headache and migraine. Many in the form of ingestants (wine, chocolate), strong smells, bright lights, and most commonly stress.
A common method of treating migraine or chronic headache is to keep a diary and try to identify your triggers, and hopefully you can find one or two that are predictable and that you can actually control - the lucky few. For the rest there are either too many triggers, or there isn't a consistent pattern, or you can't avoid them (i.e. driving, stress).
All to often the "avoid the triggers" or "just relax" doesn't work.
So what do all these factors have in common? The trigeminocervical nucleus in the brainstem.
When we all eat certain foods particular chemicals in them have an effect on the lining of our mouth. Bright lights affect our cornea's, and strong smells affect the lining of our nose and sinuses. All of this normal information is relayed through the trigeminal nerve into the brainstem.
Now, we know from our earlier look into the science behind headache and migraine that a common factor in ALL headache types in an overactive brainstem. Effectively, it is sitting there like a powder keg, and the "buzz" coming in from the trigger is the "spark". The spark tips the activity over the "headache threshold" and BOOM! Migraine.
"But I have been told it is an allergy? No. An allergic reaction is your body mounting an immune response to a foreign invader. We know what allergies look like. Give someone peanuts who can't have them, cat fur, bee stings.......we see different types of allergies all the time, and what they provoke is an immune response. Your body says "Get it out".
We don't see an immune response in these cases. We just see the product of adding more information to an overloaded brainstem. Stress will do the same thing coming in through the cervical nerves.
We also know that in 80% of sufferers the upper neck is a major contributor to this overactivity, and has a treatable condition commonly overlooked by most clinicians. They just aren't trained to look for it.
In many cases after successful treatment, people again become able to tolerate wine, cheeses, chocolate........this is the true miracle of what I do. ;-)
The science is clear.
Check your neck.
Roger O'Toole is the Director and Senior Clinician of the Melbourne Headache Clinic and has over 10 years experience as a physiotherapist.