You learned to smile through the pain because “I get migraines” doesn’t land the way you hope it will.
It sounds sort of small to people who haven’t lost days, weeks, months, maybe years to thundering, nauseating neurological storms that steal your sleep, your patience, and your plans. So you nod, you wave off concerned looks, you try to keep moving.
Meanwhile, it progressively worsens over time. Your world shrinks: fewer dinners with friends, fewer workouts, and making plans just feels like setting yourself up for failure.
Why bother making plans if you’re just going to have to cancel yet again?
You start to tiptoe around life, instead of living in it.
If that story feels familiar, I want you to know I’m not just piecing this together from things I’ve heard from my clients (though it lines up well with that too).
I’m writing because I’ve lived through this myself.
My Migraine Story and The System That Left Us Hangin’
Several years ago, migraines played a major role in my life. At the worst, it progressed to the point that I was having multiple migraine attacks per week.
At first I couldn’t recognize the subconscious feelings of fear tightening the world around me; subtly starting to avoid all the brightly lit rooms, strong smells, loud places, long days, or certain foods.
I remember frequently pretending that everything was fine when my visual aura was completely erasing the face of the person I was supposed to be having a connected conversation with, causing me to lose track of the discussion.
Attacks often hit hard enough to make me lose days and nights to hiding in a dark room writhing in pain. They often felt so intense they would make me vomit from what felt like the severity of the pain.
I did what most people do at first.
I walked the medical maze, hoping for an answer that would explain everything and fix enough of it to let me breathe, but that clarity never made it’s way to me from that path.
The clinicians I met with were truly very good people AND very good providers. They cared and they tried what they could within the constraints of the system we’re in, but I kept leaving with puzzle pieces and a vague instruction to “manage stress,” “eat better,” or “get more sleep.”
None of that is wrong exactly.
It just wasn’t a plan and it definitely didn’t support me in getting from where I was then to where I wanted to go. It’s was an obscure set of generalized strategies that didn’t answer any of my burning questions:
“What is causing all of this to happen to me? Why should I be doing these things? How does any of that relate to my migraines? What does “eating better” even mean exactly? Surely these things are too simple and general to help my migraines, don’t you know how awful they are?”
It took me longer than I’d like to admit, to understand the bigger problem:
The system that I was asking to rescue me from this condition wasn’t built for what I needed.
It couldn’t walk by my side on the path to recovery and show me the way.
Modern healthcare evolved to stop bleeding, fight infection, and triage emergencies. Genuinely heroic work, and we’re all better for it. But migraines don’t usually behave like a lacerated artery.
They live at the intersection between a sensitive nervous system with sleep architecture, nutrient availability, neuromusculoskeletal input from the neck and jaw, stress physiology, etc. and the habits that either stabilize or destabilize the whole arrangement.
No single specialty pulls all of this together and shows you what to do, why and when to do it, and helps you troubleshoot when things don’t work according to plan.
So you’re handed some of the parts to your health and are asked to assemble it yourself without the set of instructions that you need.
I’m not interested at all in blaming the clinicians inside that system; I am one. I’ve seen the long days. The hours spent battling with insurance to reinstate coverage for the client that desperately needs more care. I’ve shared their constraints.
The point isn’t that “people don’t care.”
The point is that we’ve organized our care around emergencies while the things that plague us most as a society are now chronic, layered, and stubborn. If we want a different result, we need a fundamentally different structure to approach these problems.
My Vision for the Future, How I Got Here and the Support You Deserve
My story exploring this “different way” began out of mix of desperation and luck.
I grew up in a medical family. Long conversations about case studies and learning about human health around the dinner table started when I was very young. I remember listening to medical audio books on our longer drives and I developed a deep interest in sports and fitness from an early age too.
During my doctoral training in physical therapy, I started reading everything I could get my hands on about human health because I started to recognize the powerful overlap that much of our pains have with our other branches of health. I started exploring the science of exercise, nutrition, sleep, autonomic regulation, pain experience, migraine pathophysiology, etc. This set the stage for my intensive residency training where my passion and skills really began to develop.
I was remarkably fortunate enough to have a handful of incredibly talented and insightful mentors in my early career and through my residency training. They helped to guide me during my rapidly growing experience and challenge my beliefs, allowing for a much deeper and richer immersion into clinical expertise than I believe I would have been able to collect almost anywhere else.
As I gained clinical experience and worked through my residency training, I stopped asking, “What can I do to fix this?” and started asking, “What are the levers that we can pull together that will actually drive the adaptations needed for a specific goal and how can we implement these sustainably into the life of individual that I am partnered with.”
I have now partnered in so many people’s journey’s toward health and wellness in a way that few professions other than physical therapists have the chance to do.
Throughout my career I have found what it often takes to help someone to actually rediscover lasting health, from even some of the darkest corners of health decline.
I’ve seen people run again after coming to me wheel chair bound, barely able to simply stand after years of disuse and horrific hospitalizations. I’ve seen people beat the odds and lose over half their body weight, overcome their type 2 diabetes, and leave their walker behind. I saw one man return from having more than 10 years of constant 7/10 headache to “barely noticeable” 2/10 pain. I’ve seen people having 3 migraines per week get to the point where they “can’t remember the last time they had one.”
Throughout this process I began to recognize that the core of these changes was built around partnership with my clients and the science of effectively facilitating behavior change that is grounded in evidence, but tailored for individual, personalized goals.
The core of this shift in my approach revolves around this belief:
All of the knowledge about health sciences in the world is useless unless it can actually be translated into the next steps that someone can take today, next month, and a year from now that connects where they are now with where they want to go.
My clients started reporting inspiring results.
Their migraine frequency fell. Intensity often softened. The gaps between attacks grew. Eventually, many would report that months passed without incident, unless something majorly slipped up on their basic support routine or health habits.
Now I’m fully focused on helping people with migraines because it should not be the case that migraines remain the number one cause of disability in people under 50yo. I really believe this can change.
Believe That Change is Possible
First, I want to shift our focus to the first step in this entire process.
It’s the most crucial part to understand and something I wish I had believed sooner:
Believe that change is possible. It absolutely is. You don’t have to stay stuck in this cycle forever.
If you need a simple picture to anchor with, imagine your trigeminal system as a bucket.
Everything you throw at it (fragmented sleep, skipped meals, neck tension, hormones, heat waves, stress spikes) pours water in or even change the size of the bucket. Overflow of this bucket represents an attack. Click here if you want to read more about that framework in depth.
You can spend years playing whack-a-mole with individual streams, or you can learn two moves that always matter: pour in less water and intentionally make the bucket bigger.
When people hear that, they often ask for a list. But lists can feel like another set of pieces. What you need is a greater depth of understanding and a program that makes those things livable.
That’s where my work now lives. I call it the Migraine Renaissance not because I’m in love with titles but because renaissance captures what I’ve watched happen: a very practical rebirth of capacity.
We build it through movement that regulates instead of overwhelms; sleep quality that’s intentionally trained to deepen and enrich, not left to chance; nutrition and hydration that makes a high-demand brain feel safe and supported; accessible nervous-system regulation practices that shift you from threat to steadiness; attention to the neck, jaw, and shoulders that can often provoke the same migraine pain circuits; pattern-tracking that replaces guesswork with signals we can follow; and behavior design that makes all of this small enough to implement and repeat until it becomes a part of who you are.
Those are the pillars. Not exactly a checklist to tick off, but a place to start and focus your self-assessment efforts more efficiently.
I originally encountered this framework piece by piece in the literature, but it was solidified in the clinic.
Now I’ve had the rare privilege of walking the journey to recovery with people multiple times a week for months to years. You learn things about human motivation and behavior change in that kind of intentional proximity: how much effort a person can afford on a busy Tuesday, what they’ll actually do when they’re overwhelmed, which support systems survive contact with a real job, real kids, real bodies.
After watching people who came in to my clinic as wheelchair users run again, watching daily pounding headaches fade to background noise, seeing three-migraines-a-week become almost none, I realized that these changes didn’t just come from heroic willpower or from one perfect pill.
They came from narrowing the focus to the next lever we could pull, pulling it consistently, and letting physiology do what physiology does when you lower the water and build the bucket.
My client’s have taught this back to me in their own words.
One client had generally avoided exertion for years because exercise was a trigger. So we didn’t begin with the 5k he had recently been roped into (leading to a huge 3-day migraine attack). We began with five minutes of slow intentional breathing before bed, three neck-strengthening drills every other day, approachable exercise snacks, morning sunlight on his face, and a glass of water before checking emails.
When that was sustainable and he was starting to build some resilience, we added a gentle walk/jog sequence and two simple strength days. Six weeks later, his sensitivity was starting to lower.
He wasn’t “cured,” but something crucial had changed: his fear receded and his safe movement boundaries widened. His bucket was building and triggers were more manageable. The migraines that did come were sometimes quieter and shorter, less cruel. And he could now see why.
I recognize that this could sound foreign if you’ve been through what feels like everything to address this, but this is just an invitation to curiosity.
If your life has slowly arranged itself around your migraines, if you’ve stopped planning weekends, if you ration bright rooms and long conversations, ask whether the story you’re using is helping you get out.
“I’m broken” rarely leads to action and subsequent change. “I’m sensitive right now, and sensitive systems can be supported and trained” often does.
Here’s what I wish someone had told me years earlier: change is possible, but it won’t look like flipping a switch.
It looks like deciding which stream you can turn down this week and which inch of the bucket you can build.
It looks like boring fidelity to small acts that matter more than they feel like they should (consistent bedtimes, consistently mindful nutrition, consistent breath work, consistent strength done in doses that leave you stimulated, not annihilated).
It looks like noticing your patterns with enough self kindness to stay with the experiment long enough for your nervous system to believe you.
I can’t promise a cure. Migraines too individual, complex, and really are a genetic predisposition at their core, then colored by personal, situational, environmental, and behavioral factors. But that predisposition doesn’t guarantee that you have to suffer endlessly with high frequency, debilitating migraines and I can promise that when you treat this with the right framework, your system will respond.
Mine did. My clients’ have. And what returns isn’t just fewer attacks; it’s a renewed sense of ownership over your days. You stop arranging your life around what you have to avoid and start arranging it around what you want more of.
Take Action
So if today is one of those days when you’re tempted to give up, take the smallest step that honors this new story. Drink the water before the coffee. Go to bed thirty minutes earlier than you planned. Do the two neck exercises while your computer boots. Step outside and let the morning light tell your brain what time it is. Not because any one of these is magic, but because together they teach your body how to more consistently return to a balanced state of regulation.
I’m here for the long version of this work. The careful sequencing, the troubleshooting, the days that don’t go acording to plan. But even if we never speak, I want you to leave with this: you are not a fragmented collection of parts. You’re a person whose system has been sounding an alarm for a long time. These alarms take time to settle down, but they do get quieter when the environment changes. And environments are built one decision at a time.
If you want to tell me which stream (trigger) you’re turning down first or which way you’re working to build your bucket, I’ll read it. If all you can manage today is that practiced smile, I get it. I’ve worn it too. But there’s a way to let it be more than camouflage. There’s a way to make it the first sign that you’re coming back to being yourself again.
Until next time,Dr. Dylan Wells, PT, DPT, OCS, CSCSFounder of MoveWells LLC | Creator of Migraine Renaissance Weekly and Podcast
