Watson Headache Approach

The Watson Headache Approach is a systematic approach to assessing and treating headaches, migraines and other conditions.

The overall goal of the Watson Headache Approach is to allow individuals to gain control over their condition, reclaim their independence and optimise their medication usage.

In headache and migraine conditions, neck involvement isn't always obvious.

In fact, often people won’t have any loss of neck movement or even neck pain.

The Watson Headache Approach uses specific manual skills and clinical reasoning to determine if the neck is involved, and to provide treatment to contributing structures for fast results.

This method was developed by Dr Dean Watson who has refined his approach over more than 40 years of practice treating exclusively headache and migraine sufferers.

It is effective for a surprisingly wide range of head pain, migraine and dizziness disorders, many of which:

  • aren’t traditionally considered to be suitable for physio treatment
  • aren’t traditionally thought to have a relevant neck contribution
At Adelaide West Headache Clinic, the Watson Headache Approach is our starting point with all headache or migraine patients. Click here to learn more about our Headache Clinic services.

The goals of the Watson Headache Approach

The goals of the Watson Headache assessment are to determine:

  1. identify if there is a truly relevant relationship between the upper cervical spine and the headache or migraine condition, and if so;
  2. which levels are implicated and
  3. whether this is a problem that can improve with this particular treatment approach

From there, the Watson Headache Practitioner can then treat the cervical spine using advanced manual therapy skills, exercise and posture change.

If the patient has a headache or migraine at the time of examination, the aim is to identify what is capable of reducing the pain.

If there is no headache present, we aim to identify if there are particular joints that are capable of being involved in the headache or migraine pain.

Lachlan Sutherland using Watson Headache approach


Speak directly with a physio to learn how you could be headache or migraine-free!

Call us on 8356 1000 or message us TODAY

Benefits of the Watson Headache Approach

This approach offers a number of important benefits for the patient:

If the Watson Headache Approach is going to help, it should create a meaningful change in a small number of sessions. 

Often the first changes are noted after the first or second session.

The system allows both the therapist and the patient to be certain if the neck is involved.

During the assessment, this will be apparent by the pain behaviour in real-time.

This will be confirmed by change in the condition overall over time.


For a large number of patients, we find strategies that they can employ to help prevent their headaches or migraines.

Better still, we often find that certain exercises are capable of reducing or abolishing an existing headache.

It helps give control to the patient who commonly feel that they haven’t had any control, except for taking medication.

There is a benefit to the patient knowing if their neck is definitely not involved, or if it doesn’t respond to treatment.

This prevents the patient from needing to trial all the different types of therapy that are available for treating the neck.

This information helps avoid wasting both time and money.

How is the Watson Headache Approach different to other therapies?

What it involves:

What it doesn't involve:

The importance of assessing the upper cervical spine

Surprisingly, the neck is often written off as being involved in headaches or migraine conditions by some members of the medical community.

This is despite the well-documented neuroanatomy that makes the upper neck a valid potential contribution to any head pain

This page on the trigeminocervical nucleus explains more about the concept.

It is possible to determine if the neck is involved or not by a skilled assessment to the upper neck.

This assessment needs to be more than simply checking neck movement and a cursory palpation of the neck and muscles.

Using the Watson Headache Approach assessment, this can be done based on real-time information about the location of the pain and how it behaves. 

If assessment shows that the neck is not involved, this can prevent wasting time and money on treatment that isn’t going to work.

Cervical spine anatomy nerve roots - Adelaide West Physio + Pilates | Headache Clinic


Speak directly with a physio to learn how you could be headache or migraine-free!

Call us on 8356 1000 or message us TODAY

What does the Watson Headache Approach involve?

A thorough subjective examination

The first priority of the subjective examination (history-taking) is safety.

There are questions that help screen for conditions that need to be further explored medically.

You’ll speak with a physio who wants to hear the details of your condition’s behaviour, its triggers, and all the other experiences that come with it.

After all, you are the expert in what you experience.

This information is often important in helping to decide if the neck could be involved in the headaches/migraines, and if so, which areas of the neck are worth exploring.

One of the important aspects of the subjective examination is finding measures that allow both the Watson Headache Practitioner and the patient to clearly identify if there is improvement or otherwise.

A targeted objective examination

The priority of the objective or physical examination is also safety.

The first step is screening for any ligament laxity or bony deficiency, particularly following trauma like motor vehicle accident or head injuries resulting in concussion.

The objective examination involves identifying features of the neck that suggest its involvement in the head pain, headaches or migraines.

This often involves finding joints in the neck that recreate aspects of the patient’s headache or migraine experience, and most importantly, if they improve with the sustained pressure at those joints.

A diagnosis

This initial assessment will provide a provisional diagnosis of whether or not the upper cervical spine is contributing to the headache, migraine or other condition.

This is further refined over time depending on the response to treatment.

The treatment

There are a number of components to the treatment:

    • Advanced manual therapy techniques – these are delivered to the neck segments that have been identified as involved
    • Education – information about how the neck can be involved, what things to work on optimising in life, and how the exercises will help to reinforce the treatment session results
    • Exercise – both general exercise and specific neck exercises

Prevention and self-management

The aim of the Watson Headache Approach is to allow individuals to gain control of their condition and achieve successful self-management. 

It is important to know all the things that can be done to help prevent recurrence, and maintain the improvements gained with treatment.

Who is qualified to deliver Watson Headache Approach?

The Watson Headache Approach is much more than a handful of manual therapy techniques.

It is a full approach to assessment and management of headache and migraine problems.

Therefore there is a difference between receiving treatment from someone who has learnt the manual techniques secondhand compared to receiving treatment from a Watson Headache Certified Practitioner.

Lisa Vernon has completed the Level 1 course conducted by Dean Watson himself.

There are a few physios in Adelaide, including Lachlan Sutherland, who have done the Level 2 course, which takes the refinement of the techniques to the next level.  

There are only 2 physios in Adelaide who have done the Level 3 certification course to become a Watson Headache Certified Practitioner, one of which is Russell Mackenzie.

What is the next step?

If you are ready to find out if the Watson Headache Approach can deliver you headache and migraine relief, ring us on (08) 7282 0871 to organise an initial consultation.

If you’re not sure whether it is the right step for you, call us and organise a time to speak with Russell Mackenzie, Lachlan Sutherland or Lisa Vernon.

They can answer all of your questions about what the method involves and if it sounds like the logical next step for you.

You can read more about our Headache Clinic here.