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Chronic Lower Back Pain

6 Hidden Signs Your Client’s Migraines Are Actually a Nervous System Issue - A Therapist Checklist


Are We Thinking About Migraines All Wrong?

For years, we’ve been told that migraines are just vascular issues or that they stem from hormonal imbalances, stress, or diet. But what if that’s only part of the picture?

What if the real culprit behind persistent migraines is dysfunction within the nervous system itself?

As a physiotherapist or physical therapist, you already understand that pain isn’t just about the tissues—it’s about how the brain interprets threats and responds to stimuli.

The latest research in applied neurology suggests that migraines are more than just headaches—they are brain and nervous system issues at their core.

Could it be that your clients' recurring migraines are a sign of nervous system dysregulation?

If you are dedicated to thinking outside the traditional biomechanical box, and ready for this generation's next wave of health change, then read on!

The information that we are about to discuss has solutions attached to them, but not the specific applied neurology drills associated with each sign. The physical drills, solutions, and assessments to each are in our Fundamentals Of Applied Neurology Course. We will discuss this further at the end. 

Here are six hidden signs and possible SOLUTIONS that their migraines may not be just a headache problem—but a neurological one that requires a brain-first approach.  

 

 

1. Increased Sensitivity to Light, Sound, or Smells

Most people associate light sensitivity and loud noises with migraines, but here’s the real question: why is the nervous system overreacting to sensory input?

This hypersensitivity is a sign that the brainstem and trigeminal nerve are overactive, misinterpreting normal stimuli as threats. When the nervous system is on high alert, it lowers the threshold for pain—and that’s a neurological problem.

 Quick Assessment for Therapists:

  • Does your client struggle with bright office lights or computer screens?
  • Are they bothered by strong smells that others don’t notice?
  • Do they feel dizzy or overstimulated in noisy environments?

If so, their migraines are likely linked to an overstimulated nervous system, not just external triggers.

 

 

2. History of Concussions or Head Trauma (Even Minor Ones)

Even a mild concussion or whiplash injury can leave lasting neurological imbalances.

Many clients don’t connect a past head injury with their current migraines, but the nervous system does.

Why? Because head trauma can cause:

  •  Brainstem dysregulation (affecting cranial nerves and pain pathways)
  •  Vestibular dysfunction (leading to balance issues and dizziness)
  •  Increased central nervous system sensitivity (making migraine triggers worse)

Therapist Action Step:

Ask your client about any history of falls, car accidents, sports injuries, or even minor head bumps—even if they happened years ago.

If they say “Oh yeah, I hit my head a while back, but I never blacked out,” take note. Their nervous system might still be compensating for that injury, contributing to chronic migraines.

 


Do you want to learn the questions we use to ensure you ask the right questions in your evaluations?  The NLN Fundamentals Course covers it all. 

 


3. Chronic Neck Tension and Jaw Pain (TMJ Dysfunction)

Does your client grind their teeth, have TMJ pain, or always feel tight in their neck and shoulders?

This isn’t just muscle tension—this is a neurological issue involving the trigeminal nerve.

The trigeminal nerve (Cranial Nerve V) is a major player in migraine pain pathways.

It connects the jaw, head, and upper neck to the brainstem, meaning tension in these areas can trigger migraines.

Red Flags for Nervous System Involvement:

  •  Does your client clench their jaw or grind their teeth at night?
  •  Do they experience neck stiffness or pain along with their migraines?
  •  Do certain jaw movements or postures make their headaches worse?

This means their migraines are neurologically driven—not just a structural issue. Addressing the trigeminal nerve through cranial mobilization and neural drills can provide lasting relief.

 


These trigeminal nerve techniques and all the cranial nerves are a core part of the NLN Fundamentals Course. 

 

4. Balance Issues or Feeling “Off” When Moving

The vestibular system (which controls balance and spatial awareness) is directly linked to migraine activity.

If your client has a history of dizziness, vertigo, or feeling “off” in space, their migraines might actually be a neurological response to poor vestibular function.

Simple Tests for Vestibular Dysfunction:

  • Smooth Pursuit Test: Ask the client to follow a slow-moving target with their eyes. If their tracking is jerky, their nervous system may be struggling.
  • Head Impulse Test: Quick head movements causing dizziness? That’s a vestibular red flag.
  • Balance Assessment: Can they stand on one foot with their eyes closed for 30 seconds? If not, their vestibular system may be involved.

A dysregulated vestibular system can keep the brain in a state of threat, making migraines more frequent and severe.

 


Want to improve your vestibular system? The Fundamentals of Applied Neurology Course gives you step-by-step guidance on optimizing your vestibular system and accompanying neuro drills.

 

5. Increased Migraines During Stress or Poor Sleep

If a client’s migraines get worse during stressful periods, after poor sleep, or following high emotional loads, the autonomic nervous system (ANS) is likely involved.

Migraines aren’t just about triggers—they’re about how the brain interprets and responds to threats. When the ANS is stuck in fight-or-flight mode, it lowers the threshold for migraine pain.

What This Means for Therapists:

  • Clients need nervous system regulation drills—not just symptom management.
  • Training breathing exercises, vagus nerve stimulation, and heart rate variability work can reduce migraine frequency.
  • Encouraging restorative sleep strategies can make a bigger difference than dietary changes alone.

 

 

6. Migraines Are Unpredictable and Not Consistently Triggered by the Same Factors

If your client’s migraines seem random, inconsistent, or triggered by different things each time, their nervous system is likely in a hyper-reactive state.

A healthy nervous system adapts to stimuli. But when neurological dysfunction is present, the system becomes unstable, making the body react differently to the same inputs.

One day, coffee triggers a migraine; the next day, it doesn’t. This unpredictability is a hallmark of nervous system dysfunction.


The Takeaway: Stop Treating Just the Headache—Treat the Nervous System

As a physiotherapist or physical therapist, you already know that the body is deeply interconnected. Migraines aren’t just about blood vessels or hormones—they’re about neurological function, brainstem regulation, and sensory processing.

 

 

The Next Step:

Want to learn how to assess and retrain your nervous system for lasting pain relief? 


The Fundamentals of Applied Neurology Course from Next Level Neuro teaches you how to understand your brain’s role in pain and learn advanced neurological techniques to help your clients overcome chronic migraines, you need the right tools.

Discover the course here: Next Level Neuro Fundamentals

đź”— Get started today and transform the way you treat migraines in your practice!

Your clients deserve real solutions—now you have the knowledge to give them just that.

   

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