Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? A cross-sectional study

Abstract

Objective To investigate the association between the presence of self-reported neck pain in patients with migraine and clinical features, upper cervical mobility, and neck muscle performance. Methods A total of 142 patients with migraine were recruited and stratified by the presence (n = 99) or absence of self-reported neck pain (n = 43). The clinical examination included the Migraine Disability Assessment, the 12-item Allodynia Symptom Checklist, a flexion rotation test, and the Craniocervical Flexion Test. Results Migraine-related disability was reported by more than 80% in both groups ( p = 0.82). However, there was a greater prevalence and severity of cutaneous allodynia observed in the group with neck pain ( p < 0.001). Reduced upper cervical mobility was verified in 67% of the patients with neck pain and in 41% of those without neck pain ( p = 0.005). In addition, 67% of the patients with neck pain and 40% without neck pain were not able to maintain the third stage of the Craniocervical Flexion Test without compensation ( p = 0.003). Conclusions The presence of self-reported neck pain in patients with migraine was associated with a poor clinical presentation regarding cutaneous allodynia, neck mobility, and muscle function. However, there were no differences in migraine-related disability.

Subgrouping Factors Influencing Migraine Intensity in Women: A Semi‐automatic Methodology Based on Machine Learning and Information Geometry

“…We should also discuss that our sample of women with migraine was explored in a headache‐free situation to avoid migraine‐related allodynia and other concomitant symptoms. For instance, this situation also permitted the absence of neck pain during our exploration, a common symptom experienced by patients with migraine during their attacks and associated with a poor clinical presentation . It is possible that patients experiencing concomitant neck pain during migraine attacks could also exhibit different musculoskeletal impairments of the cervical spine, representing another subgroup.…”

The presence of aura is not related to changes in the cervical performance and mobility of patients with migraine

“…46,47,49 The presence of neck pain in migraineurs is also related to worse clinical presentation, including greater severity of cutaneous allodynia, reduced upper cervical mobility, and worse performance in the Craniocervical Flexion Test. 44 Despite allodynia is more prevalent in patients with aura, 24 no differences regarding the remaining outcomes were found.…”

“…26,27,43 Among the potential etiologies for developing these particular symptoms, the neck dysfunction and pain are described to have a signi cant role. [29][30][31]44 Neck pain, 31 muscle fatigue, [32][33][34] trigger points, 34 and reduced neck range of motion 36 can be related to abnormal afferences arising from the joints and muscle receptors. Therefore, it can potentially drive a mismatch between the neck, vestibular and visual inputs in the Central Nervous System (CNS).…”

Impact of Neck and/or Shoulder Pain on Headache

“…Firstly, comorbidity was reported to be associated with a lower level of physical activity and psychological well-being, a higher level of perceived stress and poorer self-rated health [8]. Second, those with this comorbidity were reported to have greater prevalence and severity of cutaneous allodynia [9]. Third, migraine may incorrectly be self-diagnosed as NSP [10] and the presence of NSP may delay initial migraine treatment beyond 30 minutes of headache onset and initiation of treatment at a greater headache pain intensity [11].…”