Migraines, POTS (Postural Orthostatic Tachycardia Syndrome), and upper neck dysfunction may seem like separate issues — but research into the Watson Headache® Approach is revealing potential links between them. If you experience migraines alongside symptoms of POTS, addressing the upper cervical spine could be an important piece of the puzzle.
What Is the Watson Headache® Approach?
The Watson technique is a gentle, precise manual therapy method developed by Dr. Dean Watson.
It focuses on the top three neck joints (C0–C3) and their influence on the brainstem’s trigeminocervical complex (TCC) — a key area involved in migraine generation.
Rather than fast manipulations, the Watson technique uses sustained, gentle pressure to temporarily reproduce your familiar headache or migraine symptoms, then ease them. Over a course of treatment, this can help desensitise the brainstem and reduce migraine frequency and intensity.
Key points about the Watson technique:
Safe, non-manipulative, and patient-controlled.
Targets the true source of migraine triggers in the upper neck.
Backed by over 25 years of clinical use and research.
Understanding POTS
POTS is a form of dysautonomia — a problem with the autonomic nervous system. When standing up, heart rate can rise by 30 beats per minute or more, leading to symptoms such as:
Dizziness or lightheadedness
Fatigue
Brain fog
Palpitations
Headaches or migraines
Many people with POTS also notice neck tension, dizziness linked to head position, and migraine-like episodes. This overlap suggests that upper cervical input may play a role in symptom severity.
The Migraine–POTS Connection
Migraines in POTS may be more than “just another symptom.” Both conditions share involvement of the brainstem, where sensory input from the neck interacts with autonomic control centres.
If the upper neck is sensitive or dysfunctional, it may send excessive signals to the brainstem, potentially worsening both migraine symptoms and autonomic instability in POTS.
How the Watson Technique May Help People with POTS and Migraines
By addressing upper cervical dysfunction, the Watson technique can:
Reduce brainstem sensitisation — calming the pathways that trigger migraines.
Improve neck-related dizziness — a common POTS symptom.
Support autonomic balance — potentially easing some POTS-related flare-ups.
While the Watson technique is not a primary treatment for POTS itself, it may provide important relief for associated migraines and neck-related symptoms.
Integrating the Watson Technique Into a POTS Care Plan
For people with both POTS and migraines:
Continue with established POTS management strategies such as hydration, salt intake, compression garments, and graded exercise.
Seek an assessment from a physiotherapist trained in the Watson technique if neck pain, dizziness, or migraine symptoms are present.
Monitor changes not only in migraine frequency but also in dizziness, fatigue, or postural tolerance.
Final Thoughts
If you live with POTS and frequent migraines, your upper neck could be an overlooked contributor. The Watson technique offers a targeted, gentle way to calm overactive brainstem pathways — potentially improving both headache control and day-to-day function.
At Head Neck and Spine Physio, we assess the whole picture — your neck, your nervous system, and your lifestyle — to help you feel more in control of your symptoms.
📞Contact Us for more information