Silent Migraine: Migraine without a headache

Nicolette Visser
January 6, 2026

What is a silent migraine?

Most people think a migraine always causes strong head pain. But for some people, migraine happens without much pain at all. This is called a silent migraine. Instead of a headache, people get problems with vision, balance, thinking, or energy levels. These symptoms can still be very upsetting and can affect daily life.

Silent migraine is often hard to diagnose because scans are usually normal and people may not feel unwell otherwise.  A detailed history is important in recognising this type of migraine.

Common symptoms of Silent Migraine

Silent migraine looks different for everyone, but common symptoms include:

  • Changes to vision, such as flashing lights, flickering, blind spots, or trouble reading
  • Brain fog, feeling slow, fuzzy, or unable to think clearly
  • Dizziness or feeling unsteady
  • Sensitivity to light or noise
  • Ringing in the ears or ear pressure
  • Strong tiredness or feeling “washed out” afterwards

Visual changes often last 20 to 60 minutes. After this, people may feel mentally tired or foggy for several hours. Sleep often helps symptoms settle.

How neck physiotherapy can help treat silent migraines

The neck can play a role in silent migraines as the upper segments of the neck have close connections to the parts of the brain involved in migraine (via the trigeminocervical nucleus).

Research shows that when these neck segments display dysfunction or are unhappy in some way, they can irritate or over-activate migraine pathways in the brain. This can make symptoms like visual changes, dizziness, or brain fog more likely — even when there is no headache.

Physiotherapy for silent migraine focuses on a detailed and specific neck assessment and how it affects the migraine system.

The Watson Headache® Approach is a specialised type of physiotherapy used for migraine and headache conditions. It includes:

  • Careful testing of the upper neck joints
  • Finding specific areas linked to migraine symptoms
  • Gentle, precise, targeted hands-on treatment (not forceful cracking)
  • Education to help people understand and manage migraine symptoms

Research shows this approach can help people with silent migraine have:

  • Fewer migraine episodes
  • Milder symptoms
  • Better ability to cope with daily activities

Associated silent migraine symptoms

Many people with silent migraine also notice:

  • Associated Neck stiffness or tightness
  • Symptoms during or after long sitting, travel, or busy weeks
  • Episodes that seem to happen without a clear trigger

Who can benefit from silent migraine physiotherapy?

Physiotherapy may help if you:

  • Have visual changes, brain fog, or dizziness without a headache
  • Have been told you have migraine or silent migraine
  • Notice neck stiffness around migraine episodes
  • Have normal scans but ongoing symptoms
  • Cannot tolerate or get enough relief from medication

Book an initial physiotherapy assessment for a suspected silent migraine

A full assessment is important to make sure physiotherapy is right for you. For many people, physiotherapy using the Watson Headache® Approach can help calm the migraine system and reduce how often symptoms happen and the severity of symptoms.

If your symptoms don’t match what you expect a migraine to look like, a physiotherapy assessment may help provide answers. Book an initial appointment today with the Headache Neck and Jaw Clinic to assess your silent migraine symptoms. Our Brisbane and Gold Coast physiotherapy clinics specialise in the treatment of complex head, neck and jaw conditions.