Chronic migraines affect around 2% of people across the world, according to The Migraine Trust, and a high number of those affected deal with significant impairment during migraine attacks. More recent studies have shown that many individuals who deal with migraines also experience neck pain. The neck and head are obviously closely connected, but what’s the link between neck pain and migraines? Do migraines result in neck pain, or is neck pain causing your migraines?
Diagnosis
Neck pain is common, and you can have more than one cause of neck pain. Your evaluation will include a medical history, physical examination, and possibly diagnostic tests. Before you see your doctor, try to track the frequency, duration, and severity of your pain. Also, be sure to note the timing of factors that could also contribute to your neck pain—such as long hours in a position that strains your neck.
Using a pain diary for a few weeks or longer can help you and your doctor see if there is a trend or an identifiable pattern when it comes to your migraines and your neck pain. In addition to talking with you about your medical history and your pain/headache diary, your doctor will also examine you.
Your doctor will check whether you have tenderness, tightness, or stiffness of your neck muscles and will look for any signs of an injury. Your physical examination may also include a full neurological examination and an eye examination.
If your symptom history suggests a strong pattern of neck pain associated with migraine, and your physical examination does not suggest a neck problem, then your doctor may consider your neck pain to be a part of your migraine, rather than a separate problem. People who have neck pain as a symptom of migraine may have stiffer neck muscles in between migraine episodes, but this is not associated with other abnormalities that are typically signs of neck problem.
Tests you might need include:
Cervical spine imaging: Imaging tests, such as X-ray, computerized tomography (CT), or magnetic resonance imaging (MRI) can be used to assess your bone, soft tissue, and muscle structure.
Electromyography (EMG) or nerve conduction studies (NCV): If there is a concern that you could have nerve involvement, such as due to inflammation, a pinched nerve, or nerve disease (like neuropathy), you may need these tests to determine whether you have nerve damage.
Blood tests: Issues like inflammation or infection may be accompanied by abnormal blood tests.
Causes of Migraine and Neck Pain
An important brain area in migraine is the trigeminocervical complex, a hub for pain nerves of the face and upper neck. Researchers think that this entire complex is activated during a migraine, which would explain why the pain extends into the neck for some patients.
Some researchers think that other inputs into the trigeminocervical complex might play a role in aggravating headaches in people with migraine. Musculoskeletal problems in the neck, like migraines, also activate nerves of the upper neck that are part of this trigeminocervical complex. Musculoskeletal problems of the neck include:
Posture. Posture problems refer to the way you hold your shoulders, walk, stand, and could even be related to where you work or the type of work you’re doing. Individuals who spend hours at a desk may be more likely to develop posture problems that affect the neck. While posture is known as a significant trigger for tension headaches, it doesn’t get the attention it should within the migraine community.
Joint disease: Wear and tear of the joints within the neck occurs as one ages, and that could cause neck pain that stimulates nerves in the neck that extend into the head. Dysfunction of the neck joints of any type could result in pain that moves up into the head, causing a migraine in individuals who are prone to them.
However, it’s important to note that while all of these issues could potentially be the cause of neck pain in migraine, researchers still are not completely sure how or why neck pain occurs as a symptom of migraine. And some patients with migraine can have neck problems completely independent of that condition, like arthritis or a pinched nerve.
