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

Cephalalgia. 2019 Oct;39(12):1500-1508. doi: 10.1177/0333102419854061. Epub 2019 May 27.

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.

Keywords: Migraine disorders; allodynia; cervical spine; headache.

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Disability Evaluation
  • Female
  • Humans
  • Hyperalgesia / epidemiology
  • Hyperalgesia / etiology
  • Male
  • Middle Aged
  • Migraine Disorders / complications*
  • Migraine Disorders / physiopathology
  • Neck Muscles / physiopathology
  • Neck Pain / epidemiology
  • Neck Pain / etiology*
  • Range of Motion, Articular / physiology
  • Surveys and Questionnaires