The Role of Physiotherapy for headache and migraine management?


Headaches and migraines can be a disabling condition, and many sufferers may have tried numerous amounts of home remedies, treatment interventions, health practitioners, specialists and may have even had surgical intervention.

World-wide, there are an estimated 1 billion people who suffer with migraines.1 This has resulted in headaches and migraines being regarded as the third highest cause of disability world-wide when combined with both Migraine and Medication Overuse Headache disorders.2 The only thing that tops this are low back pain and depression as the top two disabling conditions..

What does this mean to sufferers in Australia? If you are a sufferer, you may be one of the 3 million migraine sufferers, or one of the 7 million tension type headache sufferers in Australia.3

Are you one of the statistics in Australia who is a migraine or headache sufferer and have spent thousands of dollars to find a solution?

My name is Bertrand Doeuk, director and founder of the Brisbane Headache and Migraine Clinic ™. I have been fortunate to meet and collaborate with Dr Nicole Limberg, one of the few neurologists specialising in headache and migraine treatment and is the director of Migraine Specialist in Brisbane.

In this blog, we will briefly describe how physiotherapy has a role in headache and migraine management.

At our clinic, the majority of patients who enter our doors often have a similar story. They have suffered with ongoing debilitating chronic headaches and migraines. Some have lost their jobs due to excessive sick leave, have limited their social activities with their friends and families, and are too afraid to plan their week ahead due to the threat of another attack.

Most of the patients we see have tried numerous treatment interventions such as massage, acupuncture, chiropractor, naturopaths, osteopaths, doctors, specialists, had surgery and have even tried physiotherapy, with minimal results. This directly and indirectly costs Australians approximately $1 billion per annum.4

Despite the countless treatment interventions they may have tried, we often get the following questions asked at our clinic, “How are you going to help me?” or “What do you do that’s different that I haven’t already tried?” or, “I have already tried physiotherapy and it didn’t work, how will your physiotherapy treatment work for me?”

We often answer their questions by indicating that they must see a health practitioner who solely specialises in the field of headaches and migraines. Much like if a patient has a chronic heart condition, they would be required to see a heart specialist and not a healthcare professional who specialises in rheumatoid arthritis. I then ask the sufferer a question, “Have you previously seen a health practitioner who specialises and solely treats chronic headaches and migraines?” Most of the time they say they haven’t.

Here at the Brisbane Headache and Migraine Clinic ™, our headache clinicians have a background in physiotherapy, however have had extensive postgraduate training and education on managing chronic headache and migraine conditions. Our physiotherapists have obtained the Certified Watson Headache Practitioner titles. Currently there are around 20 Certified Watson Headache Practitioners throughout Australia. These practitioners perform a highly skilled treatment intervention that general physiotherapists do not. Hence, we often say that if you want to trial physiotherapy, then you should see a physiotherapist who is a Certified Watson Headache Practitioner and works at a dedicated headache and migraine clinic. This will give you the best outcome in managing and treating your chronic headaches and migraines.

We also often have patients who say they have seen a neurologist without success. Again, I ask, “Have you seen a neurologist who solely specialises in headache and migraine disorders?”

Most of these patients are not sure. We then obtain the assistance of Dr Nicole Limberg, as she is one of the few neurologists in Australia who specialises in headache and migraine management and treatment.

If you are one of the millions who suffer from chronic headache and migraines, we cannot stress enough how important it is that you seek assistance from a health practitioner with specialties in headache and migraine conditions. This will enable you to obtain the best possible outcome and to hopefully reduce, minimise or stop your headaches and migraines.

Written by Bertrand Doeuk | Director of The Brisbane Headache and Migraine Clinic

Certified Mulligan Concepts Practitioner
Watson Headache® Certified Practitioner


  1. Vos, T; Flaxman, AD; Naghavi, M; Lozano, R; Michaud, C; Ezzati, M; Shibuya, K; Salomon, JA et al. (Dec 15, 2012). “Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010”. Lancet 380 (9859): 2163–96.
  2. Headache disorders are third cause of disability worldwide. Steiner TJ, Birbeck GL, Jensen RH, Katsarava Z, Stovner LJ, Martelletti P. J Headache Pain. 2015
  3. Headache Disorders and Public Health, Education and Management Implications World Health Organisation, Geneva, WHO/MSD/MBD/00.9, Sept 2000
  4. Disability and economic costs of migraine in the United States: A population-based approach – X. Hu, L. Markson, R.B Lipton et al 1999 Arch.Intern. Med. 159:813-818

Note: Information on this site is not a substitute for professional medical advice