26/05/2026
What is the Brainstem?
Dr Dean Watson PhD, Musculoskeletal Physiotherapist has mentioned the Brainstem many times over the years, but what exactly is it, and why is it so important in headache, migraine and co-morbid conditions?
The brainstem sits at the base of the brain, connecting the brain to the spinal cord. It acts as a major communication and processing centre, receiving information from structures inside the head, including blood vessels and pain-sensitive tissues, as well as from the upper neck.
The upper cervical spine, particularly the structures supplied by the top three spinal nerves (C1–C3), has a close neurological relationship with the head and face. Signals arising from the neck joints, ligaments, muscles, and surrounding tissues can converge with sensory information from the trigeminal nerve within the lower brainstem. This is one reason neck dysfunction and headache are often closely linked.
The brainstem also plays an important role in pain regulation. It is influenced by chemical messengers such as Serotonin and by the body’s internal pain-control systems, often referred to as descending pain modulation mechanisms. These systems help regulate how pain signals are amplified, suppressed, or interpreted.
Importantly, much of the sensory information related to headache and migraine passes through brainstem networks before reaching higher brain centres, where pain is consciously perceived and interpreted.
For this reason, the brainstem is considered one of the key processing centres in headache and migraine physiology. In many ways, it is the neurological “hub” through which headache-related information is filtered, regulated, and transmitted, not unlike the role a black box plays in helping us understand the workings of an aircraft.
