Headache + Migraine Treatment
Still Searching for Answers After Years of Treatment?
There may be a cervical contribution to your headaches or migraines that hasn’t been properly assessed. We have a structured process to find out — and we’ll be honest with you about what we find.
Located in Williamstown, Melbourne. Accepting new patients.
You’ve tried. The headaches are still there.
If you’ve been through GP referrals, medication trials, physiotherapy, osteopathy, or chiropractic care and your headaches or migraines are still happening, you’re not alone. And you haven’t failed.
The most common reason treatment hasn’t worked isn’t that treatment was wrong. It’s that a specific structural contribution in the upper cervical spine wasn’t identified as part of the assessment. Standard clinical workups aren’t designed to look for it. It requires a targeted examination that most general practitioners and musculoskeletal clinicians don’t routinely perform.
That targeted assessment is where we start.
The Mechanism
Why do headaches and migraines keep coming back?
For a significant proportion of headache and migraine sufferers, the answer lies in the relationship between the upper cervical spine and the brainstem.
The top three joints of the neck sit adjacent to a structure called the trigeminal cervical nucleus: the region of the brainstem that processes pain signals from the head and face. When these joints are dysfunctional, they create ongoing sensitisation of this structure.
A sensitised trigeminal nucleus becomes progressively more reactive. It interprets normal inputs as threatening and triggers recurring headache and migraine episodes — even when the original cause of sensitisation is subtle and doesn’t show on standard imaging.
This is why headaches persist even when scans are normal, even without obvious neck pain, and even when other treatment has provided only partial or temporary relief. The structural driver is present but it hasn’t been looked for in the right way.
Normal scans do not rule out a cervical contribution. MRI and CT are designed to detect serious pathology, not the subtle upper cervical joint dysfunction that drives headache sensitisation. A normal scan means the imaging didn’t find what it was looking for — not that nothing is wrong.
The Method
What is the Watson Headache® Approach?
Developed by Dr Dean Watson PhD in 1997, the Watson Headache® Approach is a manual therapy methodology built on more than 25 years of clinical research into the relationship between the upper cervical spine and headache and migraine.
The approach works through a process of reproduction and resolution. Your practitioner systematically loads the upper cervical joints to determine whether they reproduce your familiar head pain. If they do, this is diagnostic: it confirms a cervical contribution and identifies which specific segments are involved. Treatment then focuses on correcting dysfunction in those segments and reducing sensitisation of the trigeminal cervical nucleus that has been sustaining your symptoms.
The Watson Headache® Approach is non-manipulative and does not involve neck cracking or high-velocity movement. Pressure is applied carefully, gradually, and only to the specific segments identified in the assessment.
The Watson Headache® Institute has published peer-reviewed research on the approach’s clinical effect on the underlying mechanisms of headache and migraine, including brainstem sensitisation. Learn more at watsonheadache.com ↗
The Assessment
How we determine whether your neck is contributing
The assessment is the most important part of the process, and the part most patients have never had before. It is not general neck treatment. It is a specific, diagnostic examination designed to identify whether the upper cervical spine is contributing to your symptoms — and if so, exactly which segments are involved.
01
Clinical history
A detailed history of your symptoms: how long, what they feel like, what makes them worse, and what you’ve already tried. This context shapes the physical assessment that follows.
02
Cervical examination
Targeted physical examination of the upper cervical joints at C1, C2, and C3. Careful, sustained pressure is applied to each segment to test whether it reproduces your typical head pain. This is the diagnostic test most patients have never had.
03
Clear findings and next steps
By the end of your first appointment you will have a clear explanation of what was found, whether a cervical contribution is present, and what treatment would involve. If we are not the right fit, we will tell you directly.
Who This May Help
Who this assessment is most relevant for
A cervical assessment is not right for everyone. Below are the presentations where it is most clinically relevant. If you’re unsure whether your situation fits, the first appointment will establish that.
Chronic headache
If your headaches are frequent or daily, have persisted despite treatment, and your investigations have come back normal, a targeted cervical assessment addresses the component that standard workups don’t examine.
Migraine
The upper cervical spine contributes to the sensitisation of the trigeminal system that drives recurring migraine. This applies across hormonal, vestibular, and cervicogenic presentations — whether you experience aura or not.
Post-concussion headache
Concussion frequently involves injury to the upper cervical spine alongside neurological impact. Persistent post-concussion headaches — particularly those originating in the neck or base of skull — often have a cervical component assessment can identify and address.
Not sure if this is right for you?
Book a free 15-minute call. We’ll tell you honestly whether an assessment is likely to be useful for your situation.
Our Approach
A specialist assessment. Not just a technique.
The Watson Headache® Approach is one of the validated clinical tools we use. It is not the whole of what we offer, and our goal is never to apply a technique for its own sake.
Melbourne Headache + Concussion Group is a specialist headache, migraine, and concussion clinic. Our philosophy: understand the cause, build a plan, guide recovery. For some patients, the Watson Approach addresses the primary driver. For others, treatment draws on a broader combination of manual therapy, vestibular rehabilitation, exercise-based rehabilitation, and coordinated care alongside your GP or neurologist.
The first appointment is a structured assessment. Everything we recommend follows from what that assessment finds.
We will always be honest about what we think we can and cannot help with. If a different approach or a different practitioner would serve you better, we will tell you at the assessment.
Headache + Migraine
Watson Headache® Approach, manual therapy, vestibular rehabilitation, targeted exercise programmes
Post-Concussion
SCAT6 assessment, Sway Medical, Safeguarding You, structured return-to-activity protocols
Coordinated care
We work alongside your GP, neurologist, or other treating practitioners and communicate where you consent to it
What to Expect
What happens at your appointments
Phase 1
Initial assessment
Detailed clinical history followed by physical examination of the upper cervical spine. By the end, you will know what we found, what it means, and what treatment would involve. If we’re not the right fit, we’ll tell you and point you toward who is.
Phase 2
Treatment phase
If assessment confirms a cervical contribution, treatment addresses the dysfunctional segments and works to reduce sensitisation of the trigeminal cervical nucleus. The goal is significant symptom improvement and a stable platform to move into self-management.
Phase 3
Self-management
Once meaningful improvement is established, your clinician provides specific exercises and strategies to maintain your progress. These are tailored to your presentation, not a generic programme. The goal is durable improvement you can maintain independently.
Our Practitioners
Trained and certified in the Watson Headache® Approach
Cliff Butler
Director, Osteopath + Concussion Specialist
- MHSc (Osteopathy), Victoria University, 2002
- AHPRA + Osteopathy Australia Registered
- Certified Watson Headache® Practitioner
- Concussion Practitioner [confirm accrediting body]
Peter Vlahos
Senior Osteopath
- [Confirm degree title], RMIT University, 2019
- AHPRA + Osteopathy Australia Registered
- Trained Practitioner, Watson Headache® Institute
- Personal experience as a migraine sufferer
Frequently Asked Questions
Questions we hear most often
This is the most common question we receive, and it’s a fair one. Standard neck treatment — whether physiotherapy, osteopathy, or chiropractic care — typically focuses on pain relief and mobility. It is not designed to identify or address the specific upper cervical joint dysfunction that maintains sensitisation of the trigeminal cervical nucleus.
The Watson Headache® Assessment is a targeted examination of the upper three cervical segments specifically. It applies systematic loading to each joint to test whether it reproduces your typical head pain. That is a different examination from general musculoskeletal assessment. If your previous treatment didn’t include this specific test, the cervical contribution to your headaches hasn’t been properly evaluated yet.
We will tell you that clearly at the end of the first appointment. If the upper cervical assessment does not reproduce your typical head pain, a cervical contribution is unlikely to be the primary driver. We won’t recommend treatment we don’t believe is clinically indicated.
In that situation, we will discuss what else may be contributing and where appropriate management might be found. We may suggest your GP, a neurologist, or another specialist pathway depending on what your history and assessment suggest.
The initial assessment is one appointment. If it confirms a cervical contribution, the treatment phase typically involves 5–6 sessions over two weeks. This concentrated approach is deliberate: the research and clinical experience underpinning the Watson Headache® Approach supports an intensive initial phase to achieve meaningful desensitisation before progressing to self-management.
Most patients notice a meaningful change in their symptom pattern during the treatment phase. If you are not noticing change by the third or fourth session, your clinician will discuss this with you honestly and review the plan.
Yes. Our approach works alongside medication management, not as a replacement for it. We do not advise patients to change or reduce their prescribed medications. That is a conversation for you and your prescribing doctor.
What we address is the physical cervical component of your symptoms. For many patients this works well in combination with existing medical management. Where it is helpful and where you consent, we are happy to communicate with your GP or neurologist.
Yes, for many post-concussion patients it is. Concussion frequently involves injury to the upper cervical spine alongside the neurological impact, particularly in high-force mechanisms. Post-concussion headaches that persist beyond the expected recovery window and that originate in the neck or base of skull are one of the presentations where a targeted cervical assessment is most clinically relevant.
We also use objective concussion assessment tools including Sway Medical as part of our broader concussion management approach. If your headaches began or significantly worsened following a head or neck injury, the first appointment will determine whether a cervical contribution is present and what the appropriate management pathway looks like.
Hormonal changes are a trigger, but the trigeminal cervical nucleus needs to be sensitised for those changes to produce a migraine. Addressing upper cervical dysfunction can reduce the level of sensitisation in the brainstem, which may reduce the frequency and severity of hormonally-triggered migraines even though the hormonal trigger itself hasn’t changed.
Whether this applies to your specific presentation is something the first appointment will establish. Peter has a particular clinical focus on hormonal and menstrual migraine and has personal experience as a migraine sufferer, which shapes how he approaches these presentations.
The assessment involves careful, sustained pressure applied to specific joints in the upper cervical spine. For some patients this is uncomfortable, particularly if the relevant segments are sensitised. The discomfort is brief and is actually part of how the assessment works: reproducing your familiar head pain during the examination is what confirms the cervical contribution.
The treatment that follows is gentle and non-manipulative. It does not involve neck cracking or high-velocity movements. Most patients find it significantly less intense than they expected.
Ready to find out if your neck is contributing?
The first appointment will give you a clear answer. If we find a cervical contribution, we’ll tell you what treatment involves. If we don’t, we’ll tell you that too and discuss what else may be driving your symptoms.
Located in Williamstown, Melbourne · (03) 9397 8877 · info@melbhcg.com.au