Why Do I Keep Getting Migraines When I'm Doing Everything Right?
Updated: Oct 29
You've cut out the foods that seemed to set them off. You're sleeping as well as you can. You drink the water, take the magnesium and try to build in breaks. And the migraines still turn up, sometimes on the days you least expected. It's exhausting, and it's easy to start wondering what you're missing.
Migraines keep coming back, even when you're doing everything right, because the problem is rarely one trigger or one habit. In my experience, there's one root cause underneath most chronic patterns: obstruction to free flow. It shows up in two ways that work together to lock a pattern in place: physical obstructions, meaning impaired flow through the neck, head and upper back (blood flow, nerve supply, fascia and lymph), and functional obstructions, meaning a nervous system carrying too much stress or threat.
Below I'll explain how those two sides of obstruction work together, why avoiding triggers often isn't enough, and the five levers I use and teach to clear them. I call this approach the Free Flow Method. I use it for chronic pain in general, and migraines are a good example of how it works.
Why do migraines keep coming back even when I avoid my triggers?
Triggers are usually the last drop in the glass, not the reason the glass is full. Think of your nervous system like a bucket. Stress, poor sleep, hormone shifts, skipped meals, bright light and weather changes all add water. A migraine happens when it overflows, which is why the same food or the same stressful day can be fine one week and set off an attack the next.
A 2024 review by Sebastianelli and colleagues puts it in similar terms. They describe stress, hormone changes and sleep deprivation as catalysts that lower the migraine threshold, making an attack more likely.
This is also why strict avoidance can backfire. In my experience, the more you guard against every possible trigger, the more your system stays on alert, and a body that's always braced tends to become more sensitive over time, not less. I look at that question properly in my post on whether you have to avoid migraine food triggers forever.
What is the root cause behind chronic migraines and headaches?
In my clinical experience, most chronic headache and migraine patterns come back to one root cause: obstruction to free flow, which shows up as physical (yin) and functional (yang) obstructions. Like two sides of the same coin, they feed each other, which is why working on only one often isn't enough.
Physical (yin) obstructions | Functional (yang) obstructions | |
What it means | Blood flow, nerve function, fascia and lymph are restricted, particularly around the neck, head and upper back | Your nervous system is working harder to keep you safe, with an increased threat or stress load, more fight-or-flight and less rest and digest |
What it can involve | Trigger points, tight muscles, joint restrictions, long hours of desk posture | Chronic stress, poor sleep, sensory overload, a body that never fully switches off |
The functional side isn't only the stress you can feel. Your body can be stuck in a chronic stress response even when you don't feel stressed. A 2017 meta-analysis by Pellegrino and colleagues pooled 85 survey studies covering 27,122 people and found stress was the most commonly endorsed migraine trigger.
Impaired flow is the other half. Long hours at a screen are great for smashing out admin, but not so great for the neck. A 2013 systematic review in Headache Medicine by Ferracini and Speciali pooled 8 studies covering 314 people and found greater forward head posture in people with migraine and tension-type headache. The authors thought posture was more likely to keep headaches going than to start them.
I go through some everyday contributors in four contributing factors behind many headaches.
Do migraines run in the family, and does that mean I'm stuck with them?
Genetics sets how sensitive your system starts out, but it doesn't decide how often migraines show up. A twin study across six countries, covering 29,717 twin pairs, estimated the heritability of migraine at between 34% and 57%, with the lowest estimate in Australia. Environmental effects that differed between the twins also contributed.
Heritability is a population estimate, not a verdict on any one person. Your genes are only ever part of the picture. What happens to us, what we're exposed to and how we look after ourselves all shape how and when migraines affect us.
I see plenty of people who have simply accepted that migraines run in the family and that they have to put up with them. A genetic tendency might make you more sensitive, but it isn't a life sentence and doesn't mean there's nothing you can do to help yourself.
Why is it so hard to get answers for migraines?
Migraine is common and disabling, yet many people still leave appointments without a clear explanation of why it keeps happening. The Global Burden of Disease study for 2019 ranked migraine second among the world's causes of disability, and first among young women. The Australian Institute of Health and Welfare estimates at least 1.7 million Australians live with migraine, and notes the true number may be higher.
Medication can be an important part of managing migraine. But when it's the only part, the underlying pattern often stays untouched. Each profession also tends to look through its own window: medication for the symptoms, the neck for the physio or chiro, diet for the nutritionist. The bigger, interconnected picture gets missed.
Symptoms are the body's language. The question is what yours are trying to tell you.
What are the five levers I use to clear the obstruction?
The five levers are the areas we can influence to restore free flow: external environment, internal environment, breathing, nervous system, and fascia and structure. You don't need a perfect life or a perfect body. If we can start lowering the stress load and improving circulation around the head and neck, there can often be a real change in how often and how intensely migraines show up.
Lever | What I look at | Examples |
1. External environment | Acute triggers, plus the background stressors that prime your body to be triggered | Foods, drinks, smells, lack of sleep; circadian disruption, chronic life stress, chemical and fragrance exposures, mould, diet |
2. Internal environment | The Chinese medicine patterns of imbalance that make headaches or migraines more likely to show up | Patterns showing up in digestion, sleep, energy and hormones |
3. Breathing | Habits that add neck tension and switch on the stress response | Over-breathing, holding your breath in tension, mouth breathing, upper chest breathing |
4. Nervous system | How safe or threatened your brain believes you are | Mismatched information from vision, balance and body position; how well you downshift into rest and digest |
5. Fascia and structure | Tissue, posture and joint function around the head, neck and upper back | Trigger points, chronic tension patterns, joint restrictions, nerve and blood flow |
The levers start outside the body and move deeper, layer by layer. In Chinese medicine, pain is often understood as flow that has become blocked. Where there is free flow, there is no pain. That's the idea behind the name. I'll go through each lever in its own post in future articles.
Trigger points are one piece of the fascia and structure lever. I cover them in headache and migraine trigger points.
How does acupuncture fit in?
Acupuncture works mainly on promoting healthy blood flow, regulating the nervous system and releasing tight muscles, which lines up with both sides of the obstruction. At Acupuncture Grove, I usually start a session with points on the feet and hands to help settle the nervous system and draw tension down and away from the head. The main local work is motor point release of key neck muscles such as the SCMs, traps and sub-occipitals.
Research on acupuncture for migraines is encouraging. In a 2016 Cochrane review of 22 trials, 41% of people who added acupuncture to usual care had their migraine frequency at least halved, compared with 17% on usual care alone.
I break down the evidence in what the research says about acupuncture for migraines and what the research says about acupuncture for tension headaches.
When people trial acupuncture, I suggest at least 6 sessions to see how you respond, though 12 can be a more realistic starting place for a chronic pattern. If someone is seeing improvements, we continue treatment to see how good we can get things, and some will then benefit from ongoing maintenance after that. There are no guarantees with any treatment, but someone with more understanding, more insight into their own pattern and some tools of their own is in a better position than someone relying on medication or outside treatment alone.
For what to expect, read about how long acupuncture takes to work and how often to come.
FAQs: Why Do I Keep Getting Migraines?
Why do I keep getting migraines even when I avoid my triggers?
Triggers are often the last drop in a full bucket. Stress load, sleep, hormones and tension in the neck lower your threshold, so the same trigger can affect you differently from one week to the next. Working on the underlying pattern usually matters more than avoiding everything.
Can neck tension cause migraines?
It can contribute. A 2013 review found greater forward head posture in people with migraine and tension-type headache, and tight neck muscles can refer pain into the head. It's usually one part of a bigger picture rather than the only cause.
Do migraines run in families?
They can, but it doesn't mean there's nothing you can do to help yourself. A six-country twin study put heritability at 34% to 57%, lowest in Australia. Genes might influence how sensitive you are, but how you live your life and what happens around you also have a massive impact on how often and how bad your migraines are.
What is the Free Flow Method?
It's the framework I use and teach for chronic pain and health in general. For migraines, it looks at one root cause, obstruction to free flow, which shows up as physical (yin) obstructions, such as impaired flow around the neck and head, and functional (yang) obstructions, such as an increased threat or stress load. Five levers can clear it: external environment, internal environment, breathing, nervous system, and fascia and structure.
How many acupuncture sessions are needed for migraines?
I suggest at least 6 sessions to see how you respond, then plan from there. For a chronic pattern, 12 can be a more realistic starting place. If someone is seeing improvements, we continue treatment to see how good we can get things. Some will then benefit from ongoing maintenance after that.
Ready to look at what's behind your migraines?
If you'd like a whole-body approach to your migraines, you're welcome to come and see me. I'll work out which obstructions and levers are driving your pattern and put together a plan with you.
If you'd like to try acupuncture for migraines in Sydney's eastern suburbs, come and see me at Acupuncture Grove in Bondi Junction. You can book online here or reach out with a question.
Also read:
Gavin Martin-Rentz is an AHPRA-registered acupuncturist and Chinese medicine practitioner at Acupuncture Grove, Bondi Junction, Sydney, with over 10 years in practice.
Acupuncture Grove services Bondi Junction, Bondi Beach, Coogee, Clovelly, Bronte, Waverley, Randwick, Maroubra, Double Bay, Watsons Bay, Vaucluse and surrounding Sydney suburbs.
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