Decoding the Headache Mystery: Are We Ignoring the Real Issue? with Dr. Jonathan Taves

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Dear listeners, what if the headache is not the problem.
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It's just the loudest way your body has learned to ask for help.
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Most of us treat a migraine the way we treat a fire alarm.
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We silence it.
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We reach for a pill, lie down in the dark room, wait for it to pass, and then we go right back to doing everything that lit the match in the first place.
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But what if the question comes is what if there's a different conversation happening inside your body, one that has been waiting for someone to finally listen to.
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That's where we will converse today.
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So hey dear listeners, welcome back to another powerful episode of Mind Meets Machine.
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I'm your host, Avik, and this is a podcast where we explore the intersection of human experience, healing, and the systems, biological, technological, and personal.
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The shape, how we live.
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And today's guest, please welcome Dr.
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Jonathan Travis.
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So welcome to the show.
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Yeah, thanks.
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I'm excited to be here.
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Amazing.
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Amazing.
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So, dear listeners, like before we delve deep into the discussion today, I'd quickly love to introduce you with Dr.
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Jonathan.
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So, Dr.
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Jonathan is a myoclinic trained doctor of physical therapy, founder of Novera Headache Center, and the person who's been quietly changing the conversation around chronic headaches and migraines by asking a question, and most practitioners skip.
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Why is this happening at all?
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Yeah.
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So I'll not take much of a time.
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Let's get started.
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Welcome to the show again.
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Yeah, I appreciate it.
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Yeah, I'm excited to jump into this topic because it's obviously it's one I care about.
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Exactly, exactly.
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It is very, very important.
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And even along with the listeners, I would also be the one who uh love to understand this one because uh I do not have a migraine, but from my childhood I has a sinus, which is, I believe, somehow similar.
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I am not the doctor, but just kind of thing which feels, but uh definitely there will be a lot of information for the listeners.
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So I have to start somewhere uh more personal, like because most people who go deep into the um I'd say speciality like this, it's not just academic.
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So there's usually a moment or a session that made this feel personal or origin.
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So what first drew you to headache specialty?
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Yeah, so oftentimes people ask me if I suffered with headaches or migraines myself.
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And uh, you know, of course, I've had head pain.
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And I mean, there was a time where I had a really debilitating, which you could probably classify as a migraine, but overall that's not necessarily where my story starts.
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I essentially graduated physical therapy school and was able to receive mentorship from some really good physical therapists that showed me what treating the neck and jaw looked like.
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And so I, yeah, I kind of latched onto that way of treating and was treating headaches and migraines.
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Uh, sorry, I was treating the neck mainly.
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And over the course of uh, let's say six months, I would uh occasionally get a patient with the diagnosis of a migraine.
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And at first I thought, okay, this is something the neurologist needs to treat.
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This is a medication that's required.
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And the patient would say, Well, I've tried all the meds, I've I've been to multiple doctors, and nothing has helped.
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And so what would happen is I would treat their neck and the migraine symptoms would reduce.
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And so it just kept happening.
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So the first dozen or so patients, I dug into the research and tried to understand what was happening.
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And essentially, our healthcare system claims to understand to an extent what's happening, but all they're looking at is the brain and the response that the brain has to pain itself.
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And there's no underlying trigger or cause that they're actually solving.
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And so they're they're, like you said, they're sort of reducing the alarm signal, but they're not understanding where the fire is or what's actually sending the signal itself.
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And so seeing that these people had an overlooked neck issue, and this was like the number one problem in their life, the most debilitating thing that they had been dealing with, kind of pushed me into there's an area of our healthcare system that's being missed, and I need to create a business model and a type of practice that caters specifically to these people because they need help.
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Understood.
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Understood.
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So, um, I mean, obviously, I love that, and uh, I think that origin's story matters because the way you got here is already telling us something about how you think about the work, right?
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So let's start with something that I think a lot of listeners are going to recognize in themselves.
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There's there's this most universal uh belief mo about the migraines and that they are generic and they are just something you have, and that managing them mostly means learning to live with them and keeping the right medication nearby.
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So I'm curious, like what does the narrative get wrong?
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Yeah, so when we think about migraines, there's all sorts of uh what we would call triggers or they present in different ways.
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So people will look for things like you know, things in their diet, hormones, barometric pressure changing, maybe it's a family history of migraines.
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And so, you know, we're looking for why is this happening to me?
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And so what we've come up with in order to really simplify how we think about migraines and understand the source, we have a what we call a three-spoke framework.
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And so we use that to evaluate every patient that we work with.
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And what I want to do is break down the three spokes so that the listener can understand for themselves how to think through their own situation.
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And these three spokes have basically been able to cover just about every type of headache or migraine.
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And so I do think it would be helpful, even for someone who's like, oh, like what about my situation?
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It feels so unique.
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So the first spoke in the framework is that the pain needs to come from somewhere.
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The brain doesn't just manifest pain out of nowhere.
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I mean, there are rare, rare situations where the brain might manifest pain from nowhere, but essentially there needs to be a trigger, a cause, some sort of tissue disruption or damage, inflammation that actually sends a pain signal.
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And so when we think about pain in the head or face, the most likely scenario is that the neck is the actual problem, the neck, the jaw, the shoulders.
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And so when those areas are irritated, we know that there's a referral pattern into the head.
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And so when we think of referred pain, think of like someone who has a heart attack, but their shoulder hurts.
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And so the problem is the heart, the shoulder's not the problem, but the brain is perceiving it as coming from somewhere else.
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So that's that's a referral pattern.
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And when we think head pain, we need to think neck, jaw, shoulders.
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And so to summarize the issue there, we're just not understanding the problem with the underlying source of pain.
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So that's number one is we need to assume that the pain comes from somewhere.
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And for just about every type of headache or migraine, it's going to be neck, jaw, shoulders, or some combination.
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Number two is we want to understand the developmental barriers.
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And this is potentially like a genetic component comes into play.
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So think of that family history.
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So the barriers that we oftentimes see are like airway issues, what could be a tongue tie, or it could be a hypermobility.
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So someone who has the diagnosis of alerge danlos, which is just like you're you're really flexible, right?
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And so oftentimes you lack the stability that our joints need in order to avoid injury.
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And these things will cause tension and stress over time.
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And they're a part of who you are, but they're not necessarily the like it doesn't mean you have to have migraines.
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It just means you are sort of uh predisposed or at higher risk of developing this sort of neck problem.
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But those are things in that, that what we call a developmental barrier category.
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So number one is the pain has to come from somewhere.
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Number two is there's usually a developmental component to it or developmental barrier.
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And then number three is that we have a so when we when we look at someone's general health, and this is where a lot of the like triggers fall into place, but when we look at someone's general health, it's going to impact their threshold for pain.
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And so when we think about hormones or gut health or stress levels, things like that, or even dehydration, like those things are impacting what your body's able to tolerate.
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And so your threshold will drop when it's under more stress because you introduced something to your system that it didn't like.
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And so oftentimes migraines get blamed for, you know, they they get tied to the like the cause gets tied to the food you ate or the stress you had at work or the hormones changing.
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But what really those things are just impacting your threshold.
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And so both dynamics are at play.
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You have tension, like you have to have a reason for your head to hurt, but then your body's ability to tolerate is also fluctuating.
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And so both things are dynamic and both things need to be addressed.
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And so we need to pay attention to things that will impact your threshold and get it as high as possible.
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Well, we also need to reduce the level of tension running through your neck, if that makes sense.
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Makes sense, makes sense, definitely.
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And um, I mean, like I think a lot of listeners they are going to recognize this definitely.
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And like you developed something called pre-spoke process, like neck mechanics, nervous system sensitivity, and the overall health.
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And obviously that's pretty different framework from how most people think about headaches.
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So, I mean, if you can walk us through like how you arrived at that, like what were you seeing in patients that made you uh, I'd say, realize the standard process was missing the full picture.
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Yeah, absolutely.
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So when I started treating headaches and migraines, it was very much this is a mechanical issue, the neck is is the issue.
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And there's a I mean, I was having a significant amount of success with that, just looking at that one component.
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I do have my own podcast.
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It's called the Headache Doctor Podcast.
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And so on that podcast, I interview other providers, specialists that are treating headaches and migraines, but these specialists are outside of the traditional medication model.
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And so what I was finding was like I would have whether it was an airway specialist or a functional medicine doctor, a nutritionist, a dietitian, and maybe it was a dentist.
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So all these different providers were finding some level of success treating the headache and migraine patient.
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And so what I had to do was understand how that fit in, like how their treatment approach fit in with what we're doing.
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And then over time, once we started to understand, okay, like this is something to look for that I would learn from another provider, and then we would implement a series of questions into our intake and say, okay, what are these patients experiencing and how how can we pull it out of them to look for patterns?
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And so what we started to see was these three things come up over and over again.
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And so the the three spokes in the framework have come from, you know, it's probably over 1,500 people that we've seen and treated over the last seven, eight years.
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And so we've been able to look at the data, understand like what are the patterns, what are the three things that if someone's going to get stuck, it's because we're missing one of these three.
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And so once we have all three and we have a more comprehensive plan, it feels like, you know, just about anyone can find the relief they're looking for outside of meds.
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Exactly.
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And of those three spokes, like which one tends to surprise people the most, the one they didn't expect to be the part of the conversation.
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Yeah, I would say it really depends on their experience with their headaches or migraines.
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For example, oftentimes if it's a hormonal migraine, people will intuitively think, oh, it's my hormones.
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Like my hormones are the issue.
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Or if it's something that they have a food sensitivity to, it's like gluten dairy, and they avoid gluten and dairy, they'll think, okay, it's more diet-related.
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And so oftentimes we surprise people when they have those strong triggers when we say, well, actually your neck is the source of the pain, and these things are just impacting your threshold.
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And sometimes it takes people a little bit to understand that, but usually within the first session, we we're able to reproduce their migraine and say, Do you see how the pain's actually coming from here?
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And those other things make it harder to tolerate that pain when you when you introduce that food or your hormones fluctuate.
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But then we have people that have a, I would say they have a strong neck component, like they just carry a bunch of tension.
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And then we'll bring up something like, do you realize that you have a tongue tie restriction and you your airway is underdeveloped in the sense like you have a hard time breathing through your nose.
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And so you're compensating by mouth breathing all the time, and your sleep is impacted by that.
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And we'll we'll sort of connect these dots, and then people will have these light bulb moments where they'll go, Oh, like that's why I'm just tight all the time, because my body's trying so hard uh just to breathe or to swallow or to, you know, um, because they're they're the restrictions that they're feeling and the compensation patterns they've developed over time are there for a reason.
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And uh so we work on their neck, but then we try to break down those other barriers, and that that can be fairly surprising for people as well.
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Exactly, exactly.
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And um, okay, definitely.
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And along with that, definitely I don't uh I want to ask you about like real life and the everyday part also, like something you mentioned in your bio, I mean it actually stayed with me, is like helping people break free from the fear of their next uh migraine.
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I mean it happens, right?
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So the I mean uh it definitely that phrase is doing a lot of work.
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So because I think for someone who lives with this, uh the migraine itself almost becomes a secondary to uh the anxiety around when it's uh coming back and back.
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So the way it shapes your decisions, your plans, how much of yourself you hold back just in case.
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So, what does that fear actually look like in the people who come to you?
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Yeah, it it's very debilitating.
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I mean, it uh their whole life can be catered to, I mean, so for example, there our average patient might have a weekly migraine or a few migraines every week, and then there's days where they feel fine.
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But the problem is that they don't know when their day is going to be disrupted.
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Sometimes people do have a predictable pattern, and it's like, okay, in the morning after I do this thing, and they can avoid it, and as long as they avoid the thing, then they're relatively okay.
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But even in that scenario, you you're going through life just avoiding things.
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But I would say the majority of people we see um have all sorts of different triggers and their migraines are just gonna hit sort of randomly.
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And so what happens is when you try to plan social events or you think about like life, life is predictable, but when your migraines are not predictable, then you're just reactively canceling, whether it's, you know, I can't go into work or you know, my kids' basketball game I have to miss.
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But the big ones are what really cause people to make like look for a change and and try to find a solution.
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And those are like, you know, I I don't want to go on vacation with my family because I don't know if I'm just gonna be miserable the whole time, and it feels worse to be miserable when I'm away from home.
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Or I I don't want to just like be existing as a mom or a parent, and I don't know when it's gonna hit.
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And when it hits, I just basically have to keep the kids alive and I'm not present.
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Like that's a big one for people.
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Um, and so this sort of going through life in a reactive way, relying on medication, and oftentimes cements don't even work, it's just very disruptive.
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And people feel like they're just sort of stuck in this survival mode with you know little hope of getting out of it because our healthcare system really doesn't provide a solution outside of meds.
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And so, yeah, it's it's really challenging.
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And so when someone is living inside the fear, is there a pattern that you notice in how they talk about themselves or how they explain their limitations to other people?
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Yeah, I would say oftentimes, you know, having having headache or migraine symptoms, debilitating headaches or migraines, it's uh it's not like you're walking around with a cast or you know, you're missing a leg.
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It's not a visible impairment that people can identify with or empathize with.
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And so, and and because the I mean, the number of people that have headaches of any type is large.
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Like it, you know, a large percentage of people.
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And so when you have debilitating migraines, oftentimes you get people that, you know, they they don't understand, but they act like they do.
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Um, and and so it's really hard for people to sort of be vulnerable about their symptoms and and like use their migraine as an excuse to get out of things, even though it is and should be a reasonable excuse just because it's so debilitating.
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And so to answer your question, what I often see is people they're afraid to share it, they'll just cancel plans or you know, not show up or not plan things, which is a big part of it, because they they don't want to have to cancel.
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And so oftentimes people won't necessarily know that they have frequent headaches or migraines because it's it's not necessarily visible and you just basically won't see these these people engage like others do.
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Yeah, so it's more like they don't communicate it like they would want to or like they feel would be appropriate just because they don't want to be a burden on everyone else or misunderstood.
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Exactly.
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Oh, and uh for someone who's listening right now and they are just nodding along, uh they have uh tried medication, maybe it works uh sometimes and sometimes it does not.
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Uh maybe they are just accepted that this is as their kind of permanent habits or permanent baseline.
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So, what does a root cause approach actually look like in practice?
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Yeah, a root cause approach.
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So there's a there's a few components of it.
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I mean, I laid out the three-spoke framework.
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I would say our role as providers, as physical therapists, is to incorporate movement.
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So if there was sort of a simplified message here, the problem is that the body isn't moving the way it should.
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So the neck, the jaw, the shoulders, and and that movement, that function is something that we need to implement into our daily lives.
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And so, really across the globe, but especially developed countries where we sit in front of a computer most of the day, our heads weigh 10 to 12 pounds.
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And so it's it's a it's the weight of a bowling ball.
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It's pretty heavy.
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And so when we're sedentary, when we don't move, our our body carries a level of stress that's over time builds up and then leads to a lot of these issues.
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And then, of course, we have like the whiplash injuries and trauma to the neck itself.
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And there's a whole lot of reasons why someone would present with this problem.
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Think of it like um if someone didn't brush or floss their teeth and then they went to the dentist and they were confused at why their mouth hurt, and they said, like, why does my mouth hurt?
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It wouldn't, the the dentist would wouldn't necessarily look for someone punching you in the mouth.
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It would just be all the things over time that impacted the health of your of your teeth.
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And the same is true here.
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Like, if we don't do anything to keep our body healthy and our physical bodies healthy, that wear and tear over time is just going to show up.
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And so what I would say is like just get up, move, incorporate exercise into your life if you if you have the capacity for it and if you have the ability with your symptoms to just like get some cardio in, that sort of thing, get your heart rate up.
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Uh, and then little movements throughout the day can be super helpful.
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So whether it's like a little chin tuck or something to stretch the pecks or the shoulders, those little things can be super helpful.
00:20:18.079 --> 00:20:22.880
When everything's forward, we want to like understand how to get our bodies to move in the opposite direction.
00:20:23.119 --> 00:20:28.640
And so there's sort of the specific exercise and general exercise, like those components.
00:20:28.799 --> 00:20:31.759
We want to encourage everyone to to move in that direction.
00:20:32.960 --> 00:20:33.519
Exactly.
00:20:33.759 --> 00:20:34.640
Exactly true.
00:20:35.200 --> 00:20:53.680
And um, okay, and I definitely love to ask here one more thing is like uh because I think one of the reasons people stay on medication long term is not about the stubbornness, it's just because they have tried a lot of things, other things, and they have had kind of setbacks.
00:20:54.480 --> 00:20:58.880
They had a few good weeks and then something triggered again, right?
00:20:59.279 --> 00:21:04.160
And that felt like proof that nothing really changes.
00:21:04.319 --> 00:21:05.920
So, what tends to happen in that moment?
00:21:06.000 --> 00:21:08.880
And how do you help uh someone stay in that process?
00:21:08.960 --> 00:21:13.359
Like what's I mean when it's not going linearly, right?
00:21:13.599 --> 00:21:14.079
Yeah.
00:21:14.960 --> 00:21:28.640
So one of the most helpful things that I think I can say to answer that question is the what we want to do is understand how the body operates, whether that's physically or systemically, like it looking at someone's general health.
00:21:28.720 --> 00:21:32.799
And so oftentimes we get caught up in finding like the one thing that's wrong.
00:21:32.960 --> 00:21:39.359
Like, what's the one thing that that I'm doing wrong that when I fix that thing, everything else just gets better.
00:21:39.519 --> 00:21:42.400
And oftentimes it's not quite that simple.
00:21:42.640 --> 00:21:54.640
And so what we need to do is evaluate our our lifestyle and the things that we're doing through the lens of is this, is this generally improving my health, or is it just a band aid?
00:21:54.799 --> 00:21:55.119
Right.
00:21:55.279 --> 00:22:01.759
So when we think of like medication, it's usually gonna fit almost always, it's going to fit into So, like this is masking symptoms.
00:22:01.839 --> 00:22:03.920
This is changing my perception of pain.
00:22:04.079 --> 00:22:05.920
It's muting the pain signal.
00:22:06.079 --> 00:22:08.079
Something like that is happening with medication.
00:22:08.160 --> 00:22:14.160
So that's not necessarily like something we're moving towards that's sustainable or generally healthy.
00:22:14.400 --> 00:22:23.200
So when we think of the things that we should stick with, these are things like improving sleep, incorporating movement, improving our diet and exercising.
00:22:23.359 --> 00:22:25.759
So these are the things that improve general health.
00:22:25.839 --> 00:22:34.240
And we shouldn't necessarily look at those as like temporary fixes, and okay, I changed it and then it worked for a little bit and then it stopped working.
00:22:34.319 --> 00:22:35.759
And so it doesn't really matter.
00:22:35.920 --> 00:22:39.519
No, those things we want to stick with and just continue doing.
00:22:39.680 --> 00:22:47.200
And so what the whole equation here is usually when we first interact with people, leading up to that point, time has been against them.
00:22:47.359 --> 00:22:52.559
So the stress in their neck increases, their general health may be kind of out of whack, they're in pain all the time.
00:22:52.640 --> 00:22:56.400
So things are just generally kind of deteriorating in their health.
00:22:56.559 --> 00:23:00.960
And so what we want to do is just shift it so that time is on their side.
00:23:01.119 --> 00:23:05.519
And when time's on your side, you can have a good week and then you can have a bad week.
00:23:05.599 --> 00:23:06.799
Like it's not linear.
00:23:06.960 --> 00:23:23.519
But as long as we do the things that are helpful to you and we get time on your side, then what happens is over time we see this general reduction in your symptoms, but it's usually not this like quick fix or nothing, usually nothing good in life is like as a general principle.
00:23:23.599 --> 00:23:26.319
Like we just need to stick with things over time.
00:23:27.839 --> 00:23:48.559
So, but there's definitely like uh I want to ask, like, it's just really for the person who's been listening quietly this whole time, but the one who's had migraines for years and years, who's tired things, like maybe stopped believing that anything will really work, and who hasn't told anyone how much this is actually costing them.
00:23:48.640 --> 00:23:56.640
So, how would you I mean, what would you want them to hear right now so that it feels that belief, that comfort, and everything?
00:23:56.960 --> 00:23:58.559
Yeah, a few things.
00:23:58.720 --> 00:24:05.440
Like I said, we've we've had probably north of 1,500 people that we've worked with, all different types of headaches and migraines.
00:24:05.839 --> 00:24:10.000
And I can I can honestly say that nearly all of them felt that way.
00:24:10.240 --> 00:24:20.400
Tried everything, nothing helps, kind of given up hope, had spent lots of money on you know, investing in their health, trying things that gave them hope and then failed.
00:24:20.559 --> 00:24:33.279
And so what I would what I would encourage someone to do is not rely on uh like Novera Headache center, but rely on the process and understand that your body can improve and you can heal.
00:24:33.440 --> 00:24:40.319
We just need to understand those components, those basic components and how they relate to your story, and then get time on your side.
00:24:40.480 --> 00:24:45.839
And so what that's essentially what we're doing with people is we're empowering them by educating them.
00:24:46.000 --> 00:24:51.759
And so once they understand these concepts, it feels less like, oh, I'm trying some risky product.
00:24:51.920 --> 00:24:56.400
And it's like, oh, this makes sense because I I understand how the body should work.
00:24:56.559 --> 00:25:08.000
And when we when we look at it in this broken down like three categories and how that relates to you specifically, then it feels empowering because you actually have something to kind of latch on to.
00:25:08.480 --> 00:25:16.079
Um, and so just like in the dental world, if your teeth hurt, um, the solution isn't like, oh, you just didn't have feelings the whole time.
00:25:16.240 --> 00:25:17.440
No, that's not the solution.
00:25:17.599 --> 00:25:25.279
The solution is like you need to understand how to take care of your dental health by the food you eat, the preventative care, and all that good stuff, right?
00:25:25.359 --> 00:25:28.720
Like all that good stuff is what we want to like provide people with.
00:25:28.880 --> 00:25:31.839
And that's what we talk about all the time on the Headache Doctor podcast.
00:25:31.920 --> 00:25:46.400
So so if someone's really interested in learning more, I would I would hop on over that and uh um yeah, and and give it a listen because it's it's going to be helpful if you're like, hey, I'm I'm just tired of medication and would love to try something else.
00:25:46.799 --> 00:25:51.119
And so if someone was just connect with you, which would be the great medium to connect?
00:25:51.519 --> 00:25:55.359
Yeah, our website is uh www.noveraheadachecenter.com.
00:25:55.440 --> 00:25:59.039
So N-O-V is in Victor E-R-A Headachecenter.com.
00:25:59.200 --> 00:26:07.039
You can book a call with us, and uh, we have we have options for people virtually, and then we have a community we're developing.
00:26:07.200 --> 00:26:14.160
That's a that's a pretty low monthly fee, and then we have our in-person care and and we have people travel to us all the time.
00:26:14.319 --> 00:26:18.799
These are big problems, so we understand like what that looks like.
00:26:18.960 --> 00:26:27.519
But and and then also the headache doctor podcast, um, we have social media channels through Novara Headache Center and then the headache doctor.
00:26:27.920 --> 00:26:32.079
And so I would find us um through through one of those means.
00:26:32.160 --> 00:26:36.480
If you just want to know more, go to the headache doctor podcast uh or our website.
00:26:36.960 --> 00:26:37.519
Amazing.
00:26:37.680 --> 00:26:41.680
So, dear listeners, we'll make sure that all of that will be in the show notes.
00:26:41.839 --> 00:26:52.960
And if you are driving, running, or maybe lying in a dark room right now, just check the description after and the links will be there as well.
00:26:53.200 --> 00:26:56.400
And that's it after today's episode on Mind Means Machine.
00:26:56.480 --> 00:26:57.759
And thank you so much, Dr.
00:26:58.000 --> 00:27:04.880
Jonathan, for bringing this level of honesty and uh clarity to your conversation that so many people need.
00:27:05.279 --> 00:27:09.440
And for the for the listeners, I have to say that if you're listening right now, maybe you'll be listening later.
00:27:09.599 --> 00:27:18.880
If this episode touched something, share it with someone who might need to hear it, but not to fix them, just to let them know that they are not alone in this.
00:27:18.960 --> 00:27:23.119
And that that there might be a different question worth asking.
00:27:23.759 --> 00:27:26.720
So, with this hope, this is your host, Abek, and this is Mind Means Machine.
00:27:26.960 --> 00:27:29.519
Take care of your body, and I'll meet you in the next one.
00:27:29.839 --> 00:27:30.400
Thank you so much.