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Writer's pictureRyan Schulz

Headaches And Migraines: Assessing Your Pain From The Bottom Up





First, let’s clarify. By bottom up, we actually mean from the NECK up. Typically, when someone goes to a specialist for relief from headaches or migraines, an assessment is performed from the top down. In other words, it is often assumed that headaches and migraines (especially those that are chronic) originate in the brain. The current medications used for headache and migraine sufferers focus on desensitizing the brainstem to either prevent or stop the pain.


Research done way back in 1888 found that migraines were mostly related to sensitized central structures of the nervous system. Specifically, the brain stem. That concept was not pursued in the medical system for many years. Now, research is circling back to the “sensitized brain stem” phenomenon.


Let’s say I came home from work one evening and my wife asked me, “How was your day, honey?” and I responded by saying, “IT WAS JUST FINE! WHY WOULD YOU EVEN ASK ME SUCH A RIDICULOUS QUESTION?”


Obviously, my response was rude, intense, and overly sensitized (not to mention foolish and full of consequences, but that is an article for a different type of newspaper column…).

A sensitized brainstem reacts in a similar way when it comes to headaches and migraines. Responses to noise, stress, smells, tastes, weather changes, etc. are all amplified. Another way to think of it is your brainstem as a loudspeaker and when the brainstem is sensitized, the volume is turned up too high.


Medications are typically prescribed based off of the symptoms that are present. They work to turn down the volume or to desensitize the brainstem, but also have side effects that may be detrimental in the long term and the benefits are not worth the risk.

Recent research is showing even more that the NECK is also involved in the brainstem pathway and, when specifically treated, the volume on the loudspeaker (brainstem) is able to be turned down.


With a “bottom up” approach, the NECK is addressed. What does the neck have to do with the brainstem, you ask? The top 3 vertebrate in the neck have what are called afferent nerves that intertwine with the pathway of the brainstem and can influence the sensitivity of the brainstem. If the neck is a driver of headaches and migraines, then addressing it could have just as good or even better results than any medication, procedure, or injection. Long term results are also an added bonus!


If you suffer from headaches or migraines, you NEED to have your neck assessed by a skilled professional! Contact Vertical Wall Physical Therapy today to get started on the path to relief!

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