Why You’re Still Getting Migraines: 3 Overlooked Causes of Chronic Headaches

TL;DR

If you suffer from migraines or chronic headaches, three of the most commonly overlooked, contributors are tight suboccipital muscles at the base of the skull, inadequate cellular hydration (not just water intake), and repressed emotions that drive nervous system dysregulation.

These factors directly influence the meninges, the pain-sensitive covering of the brain, and the brain’s threat-processing systems. Addressing these low-hanging fruit contributors often reduces flare frequency and intensity.

Migraine is the ultimate chronic pain condition, in my opinion, because it is completely unignorable. And it is so elusive because literally anything can cause them. However, in my clinical experience, the path to remission tends to come more from nailing the basics rather than accumulating medical advancements.

Here are the three most common low-hanging fruit causes of migraines, how they work, and how to treat them yourself.

1. Tight Suboccipital Muscles: Why the Base of Your Skull Matters

At the base of your skull sits a small, but unique, group of muscles called the suboccipital muscles (sometimes referred to anatomically as the suboccipital triangle). These muscles connect the occiput (back of the skull) to the first and second cervical vertebrae (C1 and C2).

On the surface, they look like any other skeletal muscles. But functionally, they are different.

The Medical Explanation

These muscles don't actually move any joints, instead they are densely packed with proprioceptive fibers. Proprioception being your body's awareness in space. In this case, these muscles help orient the position of your head at all time. You actually can't move your eyes without firing these muscles because both are essential to head proprioception.

If that wasn't unique enough, the suboccipital muscles also attach to the meninges; the protective membrane that encases the brain and spinal cord. The meninges are richly innervated with nociceptors (pain receptors). In fact, meningeal nociception is one of the primary anatomical sources of migraine pain.

When suboccipital muscles become chronically tight—often from forward head posture, prolonged computer work, or looking down at your phone—they can put prolonged tension on the meninges. This mechanical irritation can increase pain signaling for chronic headache and migraine sufferers.

In Plain Language

Those small muscles at the base of your skull are not just “neck muscles.” They are sensory hubs that constantly talk to your brain. When they become tight, often from posture, they can tug on the protective covering around your brain. That covering is extremely pain-sensitive.

For some people, that pull is enough to start a headache or migraine.

Why This Is Often Missed

Most migraine sufferers are evaluated for vascular issues, hormonal triggers, or medication options. Few are assessed for chronic mechanical tension at the cranio-cervical junction.

In my experience, when we address suboccipital tension through targeted chiropractic care and at-home decompression, flare frequency often decreases drastically.

Treatment

Chiropractic care is the most effective means of treating tight suboccipital muscles. Any time you adjust a joint, the muscles crossing over that joint neuroreflexively relax. But the job isn't done here because at-home exercises produce lasting results.

I recommend a device known as the DaVinci Tool, or what is simply known in my office, and amongst my patients, as “the triangle.” It allows gentle, sustained pressure to the suboccipital muscles while lying down.

One to two minutes in the morning and evening can significantly reduce baseline tension. It is also useful as a rescue strategy at the first sign of a developing headache.

This does not “cure” migraines. But it reduces one of the most common mechanical triggers.

2. Hydration: Why Drinking Water Isn’t Enough

There is no migraine that is purely physical so after checking the subocipital muscles, we look to the biochemical. The second most common low-hanging fruit cause of migraines is inadequate hydration.

The Medical Explanation

The meninges contain a lot of nociceptors (pain receptors). These receptors exist in a fluid-dependent environment supported by cerebrospinal fluid (CSF) and your hydration status.

Dehydration can reduce the hydration of your meninges. Even mild dehydration has been shown to increase headache frequency and severity in susceptible individuals.

However, hydration is not only about water intake. Cellular hydration depends on electrolyte balance—particularly sodium, potassium, magnesium, and trace minerals—which regulate fluid movement across cell membranes..

If you drink large volumes of purified water without adequate electrolytes, you may not be effectively hydrating because water is not getting into the cells, where it needs to be. In some cases, excessive plain water intake can dilute electrolytes, impairing proper fluid distribution.

In Plain Language

Your brain is wrapped in a pain-sensitive membrane that depends on proper hydration. Dehydration can cause these pain receptors to fire which can cause migraines. Regular hydration is crucial for migraine sufferers but drinking water might now be enough. Electrolytes help shuttle water into your cells, and therefore your meninges, where it is needed. This is true hydration.

Treatment

There are different formulas out there that tell you how much water per day you should be drinking. They include variables such as age, weight, activity level, and dehydrating habits. But let's face it, remembering to drink water is already hard enough, and now we want to add math...

A general rule of thumb I use with patients is aiming for approximately ¾ to 1 gallon of water per day. Hitting this mark every day is a great start and can be easily increased as your need arises.

But equally important is electrolyte support.

One product I commonly recommend is Trace Mineral Drops by Concentrace. It is simply concentrated seawater; the way we used to get our water and electrolytes before pollution became a thing. There are a lot of different electrolyte supplements out there but this one is my favorite for a few reasons:

• Contains standard electrolytes, and trace minerals, in highly bioavailable forms

• Does not contain sugar, artificial sweeteners, or food dyes which can trigger migraines in their own right

• Comes in a liquid dropper instead of a processed powder

A few drops in each glass or bottle of water throughout the day supports proper cellular hydration. I advise starting slowly (1–3 drops per glass) and gradually increasing, as it is highly concentrated and tastes salty. Otherwise I think they make water taste incredible.

One More Thing

Yes, you will have to go to the bathroom more now.

No, that is not a good enough excuse to not drink water.

But that will change.

Your body is like a sponge. If it is dehydrated, like that old crusty sponge on your sink (I know you would never, but hear me out), you think it will absorb a lot of water but it doesn't. That sponge, and your body, are like the dessert experiencing a flash flood. The water you consume just rushes right over your cells and out of you as quickly as it went in.

But a brand new sponge right out of the package is primed and ready to absorb as much water as possible. An adequately hydrated cell is more likely to absorb more water than a dehydrated one.

The more hydrated you regularly are, the more water you will absorb and the less you will urinate out.

3. Repressed Emotions and Migraine Physiology

Like all chronic pain conditions, migraine is a physical, biochemical, and emotional problem. The third lowest-hanging fruit cause of migraines is repressed emotions. The rhetoric around chronic pain is that sufferers should seek counseling because of the emotional burden it causes. Let me be clear, your emotions can be a cause of your chronic pain, not the other way around.

This is often the most uncomfortable topic but the least addressed.

When I ask patients, “What emotions are you repressing?” it often catches them off guard. Not because they are emotionally unstable. But, by design, you haven't thought about it or considered the impact they have on migraines.

The Medical Explanation

Emotional repression is not solely a psychological issue, it has measurable physiological impacts throughout your body.

Suppressing emotions activates cortical control networks (such as the prefrontal cortex) while inhibiting limbic expression (particularly the amygdala). Chronic suppression increases sympathetic nervous system tone and activates the hypothalamic–pituitary–adrenal (HPA) axis.

Persistent HPA activation elevates cortisol and catecholamines, alters inflammatory signaling, and increases muscle tension, especially in the neck and shoulders.

Studies have demonstrated associations between emotional suppression and increased pain sensitivity, higher migraine frequency, and autonomic dysregulation.

When the nervous system remains in a state of unresolved internal conflict—where emotion is present but not processed—the body often expresses that tension somatically.

Migraine becomes one of the most powerful ways the brain signals threat or overload.

In Plain Language

Humans have a tendency to ignore negative emotions. But when you do they don't actually go away, they get shoved deep down into your subconscious; waiting for you to deal with them. But whatever you don't deal with will deal with you.

Unfortunately, your brain does not speak English. It speaks through signs and symptoms. However, those signs and symptoms are often vague or suggestive of another pathology. If you "ignore" those symptoms long enough (suppressing symptoms with medications counts) then your brain will create new symptoms, worsening ones, ow wandering ones; with pain being the ultimate symptom. Migraines are designed to be unignorable. But they are nothing more than a message to you that something is still wrong. And if nothing else has worked for you, your pain might be because of repressed emotions.

This does not mean migraines are “all in your head.” It means your nervous system integrates emotional stress into physical physiology.

Treatment

Any form of talk therapy will be beneficial but mind-body counseling from a chronic pain specialist is best. This type of counseling helps draw out repressed emotions and make the connection between them and your pain.

To get started on your own, whenever you have a migraine flare, stop and analyze your current emotions and those of the last couple of days. See what kind of correlations you can make!

Why These Three Matter First

These are not the only causes of migraines and chronic headaches.

But it's best to start with the basics, the low-hanging fruit, because they are so common. They are often overlooked because the punishment doesn't fit the crime per se.

The cause of your migraine isn't one thing, though. Like all chronic pain conditions, migraine is a physical, biochemical, and an emotional problem. Starting with the basics works, but only when you address all the basics.

Written By:

Dr. Jason Winkelmann

Naturopathic doctor, Chiropractor, Chronic Pain Specialist, and Educator

Frequently Asked Questions

Can tight neck muscles really cause migraines?

Yes. The suboccipital muscles have neurological and connective tissue relationships with the meninges, which are pain-sensitive. Chronic tension at the base of the skull can contribute to headache and migraine flares

How much water should someone with migraines drink?

A general starting point is ¾ to 1 gallon per day, adjusted for size and activity. Electrolyte balance is equally important for proper cellular hydration.

Are migraines caused by stress?

Any emotional stress, especially repressed emotions, can alter your physiology in a way that can produce a migraine.

If my imaging is normal, why do I still have migraines?

Imaging cannot see everything. It cannot measure muscle tension, hydration status, or emotional stress.