Neck Pain and Migraine

Although neck pain doesn’t get a lot of attention as a migraine symptom, it’s actually more common than nausea, a hallmark symptom of migraine.1 In a recent study, 69% of people with migraine had neck disability and 92% with chronic migraine did. Researchers also found that people with migraine have more neck pain, more trigger points in the neck, more tenderness in neck muscles and less range of motion than those without migraine.2

The degree of neck pain disability in people with chronic migraine and episodic migraine was the focus of “Neck Pain Disability Is Related to the Frequency of Migraine Attacks: A Cross‐Sectional Study,” published in the June 2014 issue of the journal Headache. Researchers found that:

  • Neck pain disability is high for both people with episodic migraine (69%) and those with chronic migraine (92%).
  • People with chronic migraine are more likely to have neck pain than those with episodic migraine, but if a person has neck pain, the degree of disability is similar whether a person has episodic or chronic migraine.
  • People with chronic are more likely to have any disability due to neck problems, including severe disability, than those with episodic migraine.
  • Neck pain is a significant predictor of migraine-related disability no matter what the frequency or severity of a person’s migraine attacks are.

Researchers recommend that doctors consider the contribution of neck pain in a patient’s migraine-related disability and suggest possible techniques for managing neck pain and, thus, migraine disability. These include education about posture and self-management of neck pain as well as physical therapy.

Do you have neck pain with migraine attacks? Does the neck pain persist between migraine attacks? What techniques have you found useful in managing neck pain?

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.
View References
  1. Calhoun, A. H., Ford, S., Millen, C., Finkel, A. G., Truong, Y., & Nie, Y. (2010). The prevalence of neck pain in migraine. Headache: The Journal of Head and Face Pain, 50(8), 1273-1277.
  2. Florencio, L. L., Chaves, T. C., Carvalho, G. F., Gonçalves, M. C., Casimiro, E. C., Dach, F., Bigal, M.E. & Bevilaqua‐Grossi, D. (2014). Neck Pain Disability Is Related to the Frequency of Migraine Attacks: A Cross‐Sectional Study. Headache: The Journal of Head and Face Pain, 54(7), 1203-1210.

Comments

View Comments (21)
  • devgurl00
    1 month ago

    i get neck stiffness and pain as well, prior and during a migraine, which mine tend to be bilateral. i use rubs like tiger balm and one with CBD oil in it. both seem to help me. i don’t know much about CBD oil so i’m not going to recommend it here — please do your own research and talk to your doctor before starting it. i also find that the neck pain will radiate down my right arm to my wrist with frightful pain. it will last until i put some of the tiger balm or cbd oil on it. ibuprofen and tylenol (and stronger) do not help. currently i’m trying not to take any of those meds as i think i have rebound headaches going on.

  • ravenbird
    4 years ago

    I think I’ve had migraines for 60 of my 70+ years. Neck pain came into the picture about 20 years ago – or at least I actively started trying to do something about it around 20 years ago. I’ve got a LOT of different kinds of pillows which don’t help. What does is a soft neck brace. I may have to wear it for days but it really helps. It keeps the neck muscles warm and keeps me from sitting in strange positions in front of the computer thereby helping my posture. I’ve gone to sleep with it on but removed it in the middle of the night; very uncomfortable. It’s low cost and feels good. Can’t say it stops a migraine if one starts but it sometimes helps to keep one from going from a banked fire to an inferno.

  • jennyok
    4 years ago

    I’ve had “hormonal migraines” for 6 years. They got worse last year so now taking Topamax along with Imitrex when really bad. Pain always starts in neck on right side- starts like a rock then works its way up right side of head but now is migrating into right shoulder- almost down to elbow. My upper arm feels bruised sometimes but I didn’t injure myself. Doing acupuncture 1x a week- slow process. Thinking of starting PT for the shoulder b/c my MD wants to give me cortisone shots in shoulder. No more drugs please! This cannot be the answer! Any feedback on PT?

  • vickimarie
    4 years ago

    Hi Kerry, thank you so much for this article and all that you write.
    I have known Migraines for 43 years and like so many others, my migraines have evolved from monthly hormonal migraines to chronic near-daily pain and migraines.
    My neck is a major factor. Fifteen years ago, I was in two collisions, a year apart, that injured my neck and led to degenerative disc diseased coupled with osteoarthritis. I have had several variations of cervical injections that helped for a few years but which eventually lost effectiveness so the doctors basically shrugged, wished me luck, and sent me on my way. Before and since then I have used ice, heat, massage, acupuncture, yoga, crying, and nutritional supplements to reduce the pain. I purchases a “Ceflay” device but it wasn’t effective.
    Currently, I wake up in pain every morning between 3am and 6am. If I try to stay in bed to sleep, the pain increases and causes a migraine. If I get up and move around, take a hot shower, etc., the pain will often reduce and sometimes I can avoid the migraine. In the morning or during the day, if the neck pain and stiffness move to a breaking point, then the pain moves up the back of my skull, to the top of my head and down into my right eye. The only thing that ablates the pain is Imitrex but I always try to change the direction of the pain to avoid taking meds every day.
    I have an appointment for a consultation for Botox in February. The neurologist’s colleague told me, last year, that he had nothing to offer me other than what I was already doing. I am hoping this neurologist will consider botox injections.
    I also discovered Dr. Robert Fischell’s TED talk. His company’s device has recently been approved by the FDA. I am now researching its availability.
    I’m not chasing the cure, just some hope to recover pieces of my daily life. xovm

  • Susan L
    4 years ago

    Hi Vickimarie, Wow, your docs make me very angry. Their advice conflicts with what I’ve been told, and what I “know.” My neurologist/headache specialist/migraineur gave me a sheet of neck exercises the first time I saw him 2 years ago. He feels they are extremely important, and I have an osteoarthritis mess of a neck! I have Daily Chronic Migraines. I use a gel-filled microwaveable neck heating pad at least once a day on my neck for 20 min. before doing these exercises, and often at night before bed. It sounds like Botox would help the muscles in your shoulders and up the back of your neck, (which are standard injection spots for Botox for Migraine), A LOT. I would get a second opinion from a neurologist who is a migraine specialist, if possible. You can find a list of those names and locations on here if you do a search. The nutritional supplements list available here as well needs to be taken regularly, and over time, should protect you to some degree. At least you’ll know you’re doing something “proven” helpful to most migraine sufferers. You should limit Imitrex to twice a week, or you’ll throw yourself into rebound headaches. Keep reading the Forums and other info here – I’ve been so sick for about 9 months recently, I’ve fallen behind, and am in the process of catching up as I languish in and out of bed right now! Perhaps you can do the same. I’m looking for things I’ve missed, while you can look for things you don’t yet know, (I assume you don’t know – I don’t mean to insult you if you are fully informed, however!!) But you do need better medical advice, IMHO. Your situation seems exacerbated by poor medical treatment IMHO…my very understanding best, Jazzmine.

  • labwhisperer
    4 years ago

    I’ve had hormonal migraines for the past 20 years. Two years ago I was thrown off my bike from someone placing a rope across a road at neck level. I landed on my back and the back of my head, broke my helmet and had a horrible case of whiplash. Since then I have had chronic migraines. I have failed 3 preventative meds(indera- heart rate went in the low 50’s, topamax- spaced out, and elavil- no help). I have neck and shoulder pain almost daily but it gets much worse before I get a migraine.
    I am now doing acupuncture, massage and daily stretching. I just started deep muscle relaxation. Imitrex helps the migraine and the migraine neck pain but not all.
    Neurologist is recommending Botox, but I’m hesitant to try it.

  • poundinghead
    4 years ago

    Jin Shin Jyutsu has recently been helping me with migraine related to neck pain. I love yoga but I have to be careful not to stress my neck.

  • Mary
    4 years ago

    Yes, I have a lot of neck and shoulder pain related to chronic migraines. Frequently, my migraines start in my shoulder and then move to cover the more traditional areas as well. I receive Botox for migraines and my neurologist also locates some of the shots to cover these areas. Although the injections may initially annoy my head, thereafter I enjoy a long period during which I am free from neck and shoulder pain. It works.

  • theovenbird
    4 years ago

    I get neck pain (as well as shoulder and sometimes back pain, which I haven’t heard of as a symptom of migraines) frequently with my migraines. Often the shoulder and neck pain start before the head pain. It usually is all the the left side, the side that my migraines are most often on. When Zomig works for my migraines (which is most of the time) it takes the neck and shoulder pain away as well. I also find a warm shower helps with the back and neck pain, if I can handle standing up. Or a cold pack if I’m better staying lying down.

  • Kim DH
    4 years ago

    Neck pain is a HUGE factor for me. I always have a stiff/sore neck. I know when my suboccipital muscle is particularly painful that I’m going to have a migraine every day until I can relax it. On the advice of a physiotherapist I do stretches every day, from my glutes to my neck. I get a massage once a week and see a chiropractor once every two months. All this hasn’t solved the problem but the neck pain is under better control and the migraines a bit less frequent.

  • MigraineSal
    4 years ago

    When I started with headaches / migraines my Neurologist wasn’t sure if the neck pain I was experiencing was a side effect of the new onset migraines, or triggering them. I was very fortunate to be invited to a migraine / headache convention through a health Trust and attended in desperation after being told by a GP that I was not suffering from migraines as they were not on one side. That convention changed my world as I met my amazing Neurologist who was one of the guest speakers and I had the opportunity to speak to him and explain my symptoms after listening to him tell the audience that migraines can be bilateral. He suggested that I get my doubting GP to refer me to his private Migraine Clinic at the Spire and within a couple of months I had had two MRIs ( one of my head and a subsequent one of my cervical spine, due to findings from the head MRI and I got the diagnosis and treatment plan I needed. I have Cervical Spondylotic Disease which means that my spine has lost its natural curve and I also have trapped nerves at C4 and C6 and slight compression on my spinal cord, all of which trigger my migraines.

    Getting this diagnosis was a major turning point as I was put onto migraine preventative meds, which thankfully worked for me ( after the horrendous two week side effects period ). I attended a pain management programme and now practice mindfulness and meditation on daily basis as this helps with the neck pain, which in turn cuts down the migraine episodes. One of my top tips which I do most nights ( and every Saturday and Sunday afternoon as my G-U-I-L-T-Y P-L-E-A-S-U-R-E ! ) as a daily preventative and as a comforter when a migraine takes hold is lay the small of my neck on an iced wheaty bag on a flat bed with no pillows and I have made a wheaty bag ( filled with raw rice and dabbed with peppermint oil ) to fit around my eye area and I freeze this for use with the other wheaty bag when I am meditating. This really helps me zone out of the intensity of the pain and more often than not will lead to a deep sleep . . . my view is while I am meditating, or sleeping, I am not in the intense migraine pain. I think this helps so much when in migraine crisis because I do this most nights and my brain now associates it with comfort / soothing and relaxing.

  • Crystalrz4
    4 years ago

    Be VERY careful of your eyes. Getting them too cold or even slightly freezing them can cause Irreparable damage. Using cool or slightly cold is okay around the orbits but frozen can/will do damage.
    Best of luck with your migraines.

  • Deannaj27
    4 years ago

    I only have a migraine about once a month. But I experience headaches every single day. My neck is alwayyyys sore. I crack it all the time even though I know I shouldn’t. My posture isn’t great either :/

  • BBalla
    4 years ago

    I have suffered from neck pain for several years in addition to chronic migraine for over 20. Just yesterday I had outpatient multi-facet ablation surgery on both sides of my neck in an attempt to ease the pain. I also take physical therapy to learn how to loosen up trigger points and use a thera-cain. Great tool!

  • Nonster
    4 years ago

    How did the ablation work for you? I am scheduled to have one in January and hope it takes the pain away for me.

  • lokahiheidi
    4 years ago

    I have a Thera Cane hanging over my shoulder as I type. I had my first migraine 17 years ago, and am now chronic. Neck pain/stiffness began more gradually, I’d say over the past 5 years. Dr. thought it might be related to an old injury. Perhaps. But I wonder if it’s the other way around: chronic migraine triggers the neck issues.

  • summer33
    4 years ago

    I see a physio once a month to loosen any tight neck and shoulder muscles. I also do a lot of neck stretches to loosen these muscles which helps keep headaches to a minimum. I find if I have pain and tightness at the base of my skull/top of neck it will end up being a migraine so physio helps a lot to pin point the headache trigger joints and loosen them up

  • Luna
    4 years ago

    My stiff neck & pain is a warning sign that a migraine attack is starting. It usually goes away before the migraine attack leaves. Heat does make it tolerable. This started happening in the last year. Before that I’ve had a pain in my right side back just below the shoulder blade that was a warning sign that an attack was going to happen if I didn’t take an abortive.

  • lokahiheidi
    4 years ago

    Interesting, along with my stiff neck muscles (right side dominant, same as migraine) I have that same pain point in my right side back (close to spine), just below the shoulder blade. I’m frequently digging my thumb into that point.

  • gogo
    4 years ago

    60 mg. Cymbalta twice a day helps me quite a bit but I would love to hear about additional options.

  • DianeZ
    4 years ago

    I’ve had neck pain for years but never heard of it being related to migraines. This makes so much sense! Yin Yoga and massage help greatly, and I have ice packs that I keep on hand (even one in the freezer at work) to throw on the back of my neck. I also own a TheraCane, and a TENS unit.

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