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Migraine symptom: a stiff neck

Have you ever had a migraine symptom other people notice before you do?

My partner can tell when I have a migraine just by looking into my eyes—apparently I often get a glassy look and appear to be unfocused.

Others who are close to me (including my aforementioned partner) sometimes ask me, “Are you feeling okay?” or “Do you have a migraine?” before I have even realized for myself that I am not well. How is it they tell?

It turns out I usually give myself away in a few different ways:

  1. my posture
  2. my not being able to verbalize my thoughts quickly
  3. the way my eyes look unfocused
  4. the way I am using my hand to rub my temple
  5. the way I am using my hand to rub my neck
  6. the way I am slowly rocking my head back and forth trying to stretch my neck

Like a lot of migraine-related problems in my life, the stiff neck has gotten much more pronounced over time. My hand drifts absentmindedly to my neck (usually just one side of it is stiff) and tries to rub out the tension. I move my head around in all directions, slowly, trying to work out the tightness. And usually I don’t notice these subconscious movements until someone else points them out to me.

For me, the stiffness in my neck is usually on the same side where the migraine headache pain will soon emerge (like many people, my migraine headaches are unilateral, or one-sided, the majority of the time). As the head pain arrives, the stiffness in my neck gets more severe.

Once the migraine sets in, it’s really hard to get in a somewhat comfortable position. In addition to the achiness I get with migraine and the actual headache pain, my neck can’t seem to find a good spot on the couch or the pillow. Even during non-severe episodes, the stiffness of my neck can be distracting. Sometimes I ask Jim if he will rub my neck for just a couple of minutes. Despite all evidence to the contrary, I seem to believe that if I can just rub my neck a little bit better or position my head better, the stiffness will melt away.

Some friends I’ve talked to about this get the stiff neck only during the prodrome phase of migraine; others get it as the postdrome phase begins. (The majority of people I’ve informally quizzed about this have the most stiffness in their necks during the headache phase—that is, if they have neck stiffness at all.)

Do you have a stiff neck during any part of your migraine episode? Is there any type of massage, medication, or treatment you’ve found that makes you feel more at ease?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Cece Yuhas
    5 years ago

    I started getting Migraines when I was 4 years old, by the age of 7, I had my own Prescription for medication (my mother had migraines as well). When I was 16, I was thrown from a car and since then have had migraines with a stiff neck as a migraine symptom. I take muscle relaxers on a daily basis in addition to Topamax and Propranolol to help with prevention. I also started Botox, which has cut my Migraines down in severity and in the amount per month I have been getting, so I now have a little bit of hope. I am now 50 years old and still suffer for 3-5 days in a row before going to the emergency room for Morphine and fluids.

  • esherren
    6 years ago

    Yes, back when mine were still mostly hormonal, my husband would comment that I had the smell of an onion on my skin. Since at the time, I rarely ate onions, it was kind of odd. Also, I did get a very stiff, sore neck, then the migraine would move up and around my head to the front, which is when I had to lay down. Pounding, couldn’t bend over, ferocious pain.
    Now, he can tell because I have word finding difficulty, problems with thinking clearly, and the side of the face the pain is on droops some. And I’ve had migraines for 40+ years, just changed to chronic, daily about 20 years ago.

  • TheKimberly75
    6 years ago

    I’ve had migraines, chronic now at 56, since I was in Jr High school. For many years I’ve had my migraines begin at the base of my skull with a tingling feeling that would always grow to a full migraine sooner or later. The Drs have always said you can have migraine in your jaw, neck, etc, but until recently I didn’t realize just how much my neck hurts.
    I read an article on how neck pain is the No1 accompanying migraine symptom although most migrainueres list nausea as the first. It seems many if us take our neck pain “for granted” and just don’t think about it as a migraine symptom.
    I have a TENS Unit I wear on my neck, shoulders, or back whenever my neck starts up – it won’t take it away but it Can Help or keep it at bay!

  • Steelmagnolia
    6 years ago

    Years ago I learned that others that knew me could tell I was about to have a Migraine when I was in the grocery store one morning and the checkout clerk, who had known me all my life looked up from her register as I got in line to checkout behind a couple of other ladies and immediately asked me what was wrong while ringing for a manager to come to her line. She just took one look at me and saw something in my eyes. The manager packed my groceries after they were rung on another register, loaded me and the groceries in my car and drove me home, where my husband wrote the check for the groceries.They wouldn’t let me do anything so I got home safely. My mother was always able to tell when it was happening, but that was expected since she was my mother.

  • Garangwyn
    6 years ago

    Yes, the tendons in my neck become as tight as guitar strings. I found the most awesome massage therapist that scrapes the muscles with those ceramic spoons like you use to eat egg drop soup…you end up black and blue down your back (where a lot of my knots begin) but you feel wonderful. He even used them on my scalp. But he moved out of town the following month. I may drive 3 hours just to have him do it again. One of those massages every 2 months would go a long way towards warding off muscular/tension-triggered migraines!

  • Tracey A
    6 years ago

    Yes yes yes!! Every single migraine begins with the left side of my neck tightening up and pain building from there. I stretch, I use my thumb on pressure points at the base of my skull and lay my neck on a frozen water bottle. This can build for days and since I’ve had migraines since I was around 3 or 4 (and am now 28) I can typically push off a migraine using stretches, massage, Ibuprofen, until I am ready for it to hit (get home, day off or something). I’m sure I look like a crazy person pulling on my head sometimes! That doesn’t work when it’s fierce but for others it does! Chiropractic care helps me at times too. Especially when the pain gets terribly chronic! The whole not verbalizing very well definitely happens to me too!

  • Tracey A
    6 years ago

    Yes yes yes!! Every single migraine begins with the left side of my neck tightening up and pain building from there. I stretch, I use my thumb on pressure points at the base of my skull and lay my neck on a frozen water bottle. This can build for days and since I’ve had migraines since I was around 3 or 4 (and am now 28) I can typically push off a migraine using stretches, massage, Ibuprofen, until I am ready for it to hit (get home, day off or something). I’m sure I look like a crazy person pulling on my head sometimes! That doesn’t work when it’s fierce but for others it does! Chiropractic care helps me at times too. Especially when the pain gets terribly chronic!

  • minddoctor
    6 years ago

    My migraines started at age 39 after a car crash that involved significant whiplash, and I always have neck stiffness and/or pain before, during and sometimes even after migraines. I frequently use moist heat and massage. Botox therapy has been helpful – My understanding is that it works on the nerves, but also freezes some of the muscles involved in triggering migraines. I also swear by low dose Flexoril (5-10mg at night). This knocks the spasms out of both my jaw and neck and greatly reduces migraine intensity and frequency. It also knocks me out, as it’s highly sedative, and can not be taken long-term sadly.

  • laurahc
    6 years ago

    I started seeing a chiropractor 3x a week to work on tension in my neck and lower back. It made all the difference in the world!

  • barryolliver
    6 years ago

    Neck stiffness, yes. Neck pain, no. Well actually there is pain if I try to turn my head. I seem to unconsciously stop turning my head at such times, and resort to turning my whole body instead. It’s one of those things that people close to me pick up on well before I do.

    One thing I notice in the comments to this article is the number of people who fail to recognise a migraine is coming on until it is pointed out by someone else. I thought this was unique to me, but I’m glad that I’m not the only one with this problem.

  • nrsrcht
    6 years ago

    I too have the headache and pain in the neck on the same side. Now, the neck pain is nearly constant. I do get Osteomanipulative Therapy from a DO who specializes in it and that helps a lot. I get massages every two weeks and have for years, it helps to keep my back from becoming painful. The quality of my headaches has changed greatly over the years. I no longer have photo sensitivity nor does sound bother me, but the only meds that will relieve the headache are specifically for migraine.
    This site is so helpful, just knowing that I am not the only one with some of these symptoms is good. I am 71 years old and was hoping that age would stop the darned things, but it looks like I am not going to be finding relief any time soon.

  • tina gascon
    6 years ago

    I sometimes get a stiff neck with the headache. I usually heat up a rice bag and use it to support my neck. Cold will make my head hurt a million times worse.

  • Pamela
    6 years ago

    The stiff neck is one of my first prodrome symptoms and it intensifies as the migraine attack progresses. It doesn’t dissipate until the postdrome phase. I’ve had chiropractic care in the past that kept my neck from becoming too stiff, but the migraine still continued. Stiff neck, sensory auras (tingling of the scalp and one arm/leg), digestion problems, extreme fatigue, and cravings for carb-heavy foods always precede the pain phase for me–at least a week in advance. The pain, itself, lasts 3-5 days and treats me to impaired thoughts and speech, photophobia, phonophobia, nausea, and occasional blurred vision in addition to the first wave of symptoms. Right now, I can’t afford treatment, so I try to use home-remedy techniques: dark, quiet room, hot/cold packs, peppermint candies (nausea), ibuprofen and generic Excedrin. My boyfriend also encourages a brain-freeze technique that is hard for me to induce.

  • selco
    6 years ago

    Stiff neck, indeed. After a period of several and severe migraine attacks I often suffer of stiff neck with pain almost as intense as the migraine itself. Have tried massage and relaxing techniques, but every effort to loose up the stiff neck results in a new migraine attack. The migraine infinity loop… But with the difference that the migraine drugs doesn’t work at all. I have had my migraines for more than 40 years, and I am today better at handling the migraine than the pain from the stiff neck. Any ideas, anyone…

  • jenny0wens
    6 years ago

    The same thing happens to me. What has helped with the tightness/soreness is chiropractic care, deep tissue massage, and physical therapy to strengthen those muscles so they can endure more before they become tired. It’s not perfect by any means but I’ve greatly decreased the episodes. Also, if I feel like I’m getting into a bad cycle I have muscle relaxers that I’ll take for a day or two.

  • Tracy Grant
    6 years ago

    I get a stiff neck prior to migraines. This is my warning to drug up or it will turn into a 3 day event. It goes when the migraine becomes painful. I get the stiffness on both sides and usually rub and stretch like you do. It actually helps relieve the stiffness. I also can get a stiff neck every day at uncertain times, and by rubbing it seems to relieve that we well. Each time i think… ‘here we go’ but it goes again, so not every stiff neck turns into a migraine. I drug up around ovulation and menstrual time. That is when I tend to get the humdingers!

  • shine4him
    6 years ago

    Yes, yes, and yes. This is my biggest sign that a migraine is coming on, and my fiance can pick up on it immediately, even before I do at times. (He also says I get bad breath right before a migraine. Ick!) It’s great to have a guy who knows how to give a good neck/shoulder massage!

    One of my favorite things is a “trigger wheel” that he bought me from a sporting goods store. It’s just a 2in metal wheel attached to a handle, and rolling it up & down those long muscles on either side of your spine feels wonderful! My mom also found a neck massager at Bed Bath & Beyond (I think) that has two triangular parts that heat up and rub the back & sides of your neck in a circular motion. It’s wonderful, too!

    Oh, and I have one kinda odd, but somewhat useful thing I do as well. When I’m home & not needing to do anything, I can prop myself up on the couch and position my head against the back in a way that stretches the back of my neck (just using my body weight to add pressure). I actually prevented a migraine once by stretching like this for about 15-20 min. It’s not all that comfortable, but sometimes it helps!

  • Pamela
    6 years ago

    Interesting remark about the bad breath issue. My boyfriend noted that my body feels cooler to the touch when a migraine is either coming or already present. We’ve also noted that eating protein can help alleviate some of my migraines. In retrospect, those migraines are less severe. The bad ones don’t respond to much of anything except a dark, quiet, and cool room and a hot/cold pack. Triptans don’t faze me.

  • SED
    6 years ago

    Also that unfocused look, and people being able to tell that there is something wrong with me.

  • SED
    6 years ago

    I am just now exploring this site, and this post could have been written by me. It seems the more I explore- the more migraine symptoms I seem to have. Stiff neck is a big one..

  • rose
    6 years ago

    I definitely relate to both. I frequently get a stiff neck and shoulder. The neck pain will be on the side of the migraine but the shoulder pain is related to an older injury so it is always one sided. My migraines are usually on that side also, but preceded the injury.
    Friends and family can frequently tell before I can that I’m in the prodrome phase. Your list could have been written for me. Also, once in a migraine attack I frequently fail to recognize it for what it is. I complain to my sister or close friend that the lights are too bright, or my head hurts badly. They are used to asking if I have a migraine. In fact, writing this post is making me realize I need to take Maxalt right now.
    Regular massage and semi-regular chiropractic care has helped with neck pain. It’s not as severe, but I have not noticed a change in frequency or severity of migraine attacks. The only recent help was depakote, although it has many side effects. However the migraine reducing benefits seem to have worn off as my migraine attacks have increased from one every month or two, to one-two a week.

  • Elaine Gross
    6 years ago

    I always have neck pain with migraine. Contributing to my problem is arthritis, and dystonia. Dr. Silberstein at the Jefferson Headache Center looked at me and said “You have a neck problem”. How could he tell? My head tilts from the dystonia. I knew my head tilted, but didn’t know I had a condition that caused it to happen. I get Botox injections, and I get a few extra down the side of my neck affected by the dystonia. Another thing that really helped me with pain was physical therapy. I wish it could have lasted forever. I was given exercises to do at home, and they help. Massage is wonderful, but it’s expensive and not covered by my insurance. It amazes me how many knots I get in my shoulders & back from a migraine.

  • jenny0wens
    6 years ago

    Thanks for your post – I have similar symptoms and it’s good to know that Botox was helpful. Physical therapy has been helpful for me too.

  • trixiebarron
    6 years ago

    I have suffered from chronic migraines for 10+ years. Over the past few years I was at a point where I was taking Maxalt daily. The people that had tried Topomax and other similar preventative drugs had mixed results, but the similar complaint was the fuzzy headedness among other things. I struggle enough without dealing with that, so I am not willing to go that route. My headaches almost always begin with a stiff neck on right side and continue into my achy head. Recently I ran into my former massage therapist and she reminded me that Bowen had worked on my shoulder years ago (she was new at it at the time and I was her guinea pig) and she would like to try it for my headaches. I have had 4 treatments one week apart and I cannot begin to tell you the relief I have found. I still have a headache about once a week but not with neck pain and the severity is not even close to what it used to be. I am now going every 2 weeks and then 3 and then monthly to see how it goes. I cannot explain what Bowen is (google bowen treatment) but basically it has to do with resetting your nervous system. She has worked on my arthritic thumbs as well and I have felt relief there as well. Not sure if it might be someone else’s magic pill, but it has made a big difference in my life.

  • Judy
    6 years ago

    This post could have been written for me. I have been searching for the answer to my migraines which have again become chronic after suffering for almost 30 years. My neck is always tight with little mobility ( I had no idea people could actually turn their heads all the way over to their shoulder as well as tilt their heads back!) I was in a car accident when I was 15 which may have caused part of my problems and have a reverse curve which prohibits a lot of movement as well as having arthritis! I have constant stabbing pain under my shoulder blade which is always on the same side as where my migraine is so I am sure it is somehow all connected. I go for therapeutic massages every two weeks but they can also trigger a migraine as much as help ease the muscle tension. I use heat…love to just wrap up my neck and just sit bak and relax or stand in a hot shower. Also use Icy Hot Naturals which feels wonderful on tight muscles as well as the temples ( just be careful not to get in near your eyes!) BioFreeze is also helpful and comes in several forms and was introduced to me by my massage therapist. I take a lot of preventative medication, tried acupuncture and reflexology, physical therapy, and Botox. Hated Botox!!!! Sent my neck into such awful spasms for weeks that I was in agony and it felt like an elephant was sitting on my forehead for three months. It did alleviate my migraines but I swore I would never do it again. Unfortunately, that is the tack my new neurologist wants to take as well and was annoyed when I said no. Needless to say I haven’t been back and am off to try Integrative Medicine. Who knows….I am ready to try just about anything at this point!

  • favorst
    6 years ago

    I always have a stiff neck before a migraine. Ice helps, but many times I am not near available ice… I have found something portable that helps. On the suggestion of a friend, I tried an essentail oil blend made for tension. It doesn’t take it all away, but when applied, it cools and feels like ice. It does seem to help alleviate the overall neck discomfort. I also apply it to my forhead, temples and jawline.

  • Renae Wood
    6 years ago

    yes, naturals oils do help a lot- they are not the ultimate cure but they help! I use Do terrain oils that are fabulous. There is a blended oil called “past tense”- you roll a little on your temples, even on the back of your neck lay down in a cool, dark quiet room and close your eyes. It acts as an aromatherapy too. Breathe in deeply and relax. You will feel better quickly – usually in less than 30 minutes. Peppermint oil is good for aches. They say to put a base oil on first like coconut or olivevoil, then the peppermint, this way it will stay on longer and not soak right into your skin. but it relaxes your muscles.

  • kellytis
    6 years ago

    Ugh! I can’t believe this is posted. I have spent many many years going to doctors w/ complaints of neck pain – and they all knew I had migraines. Only one of them said that my neck pain might be caused by headaches. I didn’t believe him, as he didn’t sound very sure and he was the only one who said that. And I have been to two different neurologists (one at a migraine clinic). I’m thankful to see that I am not imagining this and that it is really due to my headaches! My insurance just stopped paying for massage therapy too! My husband, too, always says “do you have a headache?” Although he is caring, I think he is equally tired of these headaches too. So I try to hide it, but he usually knows I’m hiding it. I think I look depressed when I have a headache, and I’m a teacher – so I try really hard to stay lively and upbeat. Lately many long lasting headaches. Seeing a new neurologist soon. Feeling sorry for myself – but reading this article helps, thanks.

  • Cat Travis
    6 years ago

    I get the stiff neck, but I seem to always have a stiff neck. What I’ve noticed more than a stiff neck with my migraines is the tinnitus. I have it constant in both ears, have had it for a very long time. But in the last several years, I’ve noticed a pattern – I will get loud and strong in one ear then a few hours later I will get a severe migraine on that side. I mentioned it to my DR and even showed him the link to an article I read and he was intrigued. He’d never seen that connection before, nor had he come across anyone that mentioned having that connection. I have had people say to me that I must have a headache coming on from the look on my face, or the tone in my voice. I live alone so it’s only when I venture out for church that I come into contact with people that anyone might notice, and then it would only be from someone who knows me well.

  • angel
    6 years ago

    I can relate to your story. My right drops a little, the get glassy, my face turns a grey shade. and it all can change in a matter of minutes. My boyfriend will notice it before i do. The stiffness in my shoulders and my neck are sure sign a migraine is on it’s way. As well as the tightness or knots under my shoulder blades. I get tired and irritable. If i can’t defuse it with Imitrex fast enough, the nausea sets in and then the vomiting and well, we all know the rest.

  • Barbara
    6 years ago

    Your story sounds a lot like mine. My husband (of 35 yrs!) can tell how I’m feeling by looking into my eyes ….the first thing he does when he gets home from work! Or he can tell within minutes by my voice and attitude, he says I get very irritable before I ever realize it. He understands and is very sympathetic, but certainly very good at reading my body language. Also he has no doubt about my neck/ shoulders bothering me when I practically wear a heating pad on them, part of my daily wardrobe…even during the summer here when it’s 110° outside!

  • Beverly Militello
    6 years ago

    I get severe neck pain and stiffness with each migraine. Sometimes I find putting ice in a small Ziploc bag, and tying it off right above the ice to make it small, then I put it at the base of my skull where it meets your spine helps. That’s the only thing that helps and it only helps about 25% of the time.

  • cms3688
    6 years ago

    Your description sounds exactly like me. In fact, for a long time I really thought there was something wrong with my neck, but my doctor says my neck stiffness is caused by my migraines. I always ask my fiance to rub my neck in the hopes that it will help, even though it rarely does.

  • Andrew
    6 years ago

    I also have neck pain and stiffness on the side I get migraines. In fact, even though the migraines are pretty much under control with gabapentin and botox injections, the neck stiffness remains but comes on stronger when a headache is coming on or trying to come on. I read somewhere (can’t remember) that neck pain is not a cause of migraines but a symptom. How knows. But it does make sense that the nerve systems involved in a migraine are out of whack and those systems are all interconnected. My neurologist injects botox in my neck and down my shoulder wherever I tell him there is pain. He says it acts as a nerve block and will help with the pain.

  • amberduntley
    6 years ago

    This is a great post and absolutely true for me in general but even more lately. I’m not sure if the comment for this post is the most relevant space for this but I’m pretty much out of my mind for help. I’m not sure if you, or any other readers have had/are having Botox as a treatment, but I had my 4th round 3 weeks ago and since then have had such severe neck pain I’ve been bedridden for days on end, obviously missed work, can’t do yoga, hang out with friends, my migraines are still there only now I have the addition of THIS. I feel like I complain all the time. My neurologist isn’t taking me seriously and is such a fan of Botox as a treatment for me she doesn’t want me to stop. I NEVER want to have it again and would do anything to make this neck and shoulder pain go away and just be a miserable sack of migraine again. Has anyone else gone through this? I’m just feeling very alone and angry at my body and medicine and being stuck. Thanks in advance for letting me get this out.

  • amberduntley
    6 years ago

    Thanks for your replies – I was initially having some relief with the Botox but each round is seeming less and less successful, I’ve just gotten so used to the migraine pain that this whole new ‘not being able to move my head’ thing has sort of terrified me. I’m so sorry it’s happened to you guys, but relieved I’m not going wake up paralyzed or something! It’s just frustrating when doctors get stuck on a method of treatment when it’s obviously time to move on…not that I even know what the next step would be. I feel like I’ve been everywhere at least twice. Katie – I’m so glad to know it’s working for you and Barbara I’m SO sorry you had to have a lumbar puncture. I am very thankful that is one thing that hasn’t come up. Good thoughts and healthy heads to both of you!!

  • Barbara
    6 years ago

    I feel your pain! One of my FORMER neurologists tried Botox on me (I’m still trying different things since nothing has had a lasting effect over 40 yrs!) The week after the Botox I had a #10 migraine for 7 full days, unable to move except to the bathroom with help, vomiting the whole time .I do NOT rate my pain at a #10 lightly, that was only the 2nd time EVER, the first being when I had a spinal headache after a lumbar puncture. I never, ever, ever will do Botox again!

  • Katie M. Golden moderator
    6 years ago

    Amber- I’ve been getting Botox for 3 years now. In the beginning, it almost always triggered days of horrible Migraines for me. But then weeks of less severe headaches followed so I kept going back for more. Because I have always had severe neck and shoulder pain, my doctor originally injected into those areas as well. But like you, it was hard to hold my head up. So we cut that out as part of the injection sites and its made a huge difference.

    Do you eventually get any relief in between your injections? How long are you down and out after you get a Botox treatment? I believe people should try it for at least 3 cycles before they give up on it, which you have. I guess you need to weigh the pros and cons. And it’s always ok to get a second opinion if you feel your doctor isn’t listening to you!

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