The Surprising Connection Between Neck Pain and Migraine Attacks
Nhung Le
Lisa Brackett, 59, from Lake Worth, Florida, knows she’s in for trouble when her neck starts to hurt. “It feels like a white-hot golf ball at the base of my skull,” she says. “It’s a sickening and very distracting pain that can stop me in my tracks.”
For Brackett, that’s a sign a migraine attack is looming. “Neck pain is really common in people who have migraine,” Elizabeth W. Loder, MD, chief of the headache division at the neurology department at Brigham and Women’s Hospital in Massachusetts, tells SELF. One recent review found that about 77% of people with this complex neurological condition also experienced an achy neck before or during an episode.
But there’s also another type of neck-triggered problem, known as a cervicogenic headache, which is a different beast altogether. To correctly treat your symptoms, it helps to figure out exactly what’s going on. “The challenge is to try to distinguish if [someone has] migraine with neck pain that’s part of their migraine attack, or whether they have neck pain for some other reason,” says Dr. Loder. Here are some ways to tell the difference and what to do about them.
How to tell if your achy neck is something more
Brackett’s symptoms are part of her prodrome, or the “preheadache” phase that occurs a few hours or days before migraine’s official start. Nikki S., 32, from Chicago, feels like her neck problems actually cause her attacks, which is the case for some people. “Neck pain can frequently trigger migraine attacks for me,” she says. “I feel tightness and tingling sensations in my neck and it spreads up to my head. I sometimes feel like my head is too heavy for my neck to support and I need to lie down.”
Cervicogenic headaches, on the other hand, are due to neck problems but aren’t considered part of migraine—and can have a different treatment approach. With this condition, the bones, discs, nerves, and soft tissues of your neck or the very top of your spine are usually to blame. The pain “is primarily in the back of the head and neck,” says Shayna Y. Sanguinetti, MD, assistant professor of neurology at Hofstra Zucker School of Medicine. “This usually develops in relation to some sort of cervical disorder or lesion, such as injury, degenerative spine disease, or muscle spasm.” Other possible causes include fracture, infection, or even rheumatoid arthritis.
And while a neck ache can be a guest star with either ailment, it can feel a little different depending on the condition. Dr. Loder notes that cervicogenic headaches are more likely to occur suddenly and feel lightning bolt-like. While the pain may feel like it’s coming directly from the back of your head or neck, “it can radiate forward,” Dr. Loder says, and may affect the top of your head. Unlike with migraine, moving your neck or adding pressure to the area might make it feel worse, she says, and you might also experience one-sided pain or difficulty moving your neck.
Meanwhile, if you have a migraine attack, you’re more likely to have:
Nausea, vomiting, or sensitivity to light or noise—all telltale migraine signs.
Triggers like alcohol, lack of sleep, menstruation, and changes in weather.
Sensations that are deeply painful and throbbing, although they can vary from person to person.
Aura, or sensory symptoms, that might look like flashing lights, zigzags, or numbness and vertigo.
You may be more likely to have neck issues linked to migraine if you are younger (it’s common in children) or have chronic migraine, which is longer-lasting and involves more frequent headaches, as opposed to episodic migraine, which is defined as fewer than 15 attacks per month.
What to do if you have neck and head pain
Start tracking your symptoms.
People who experience neck pain that’s part of the prodrome are frequently misdiagnosed. Even if someone knows they have migraine, they may not realize neck pain is part of that picture and spend time focusing on the wrong problem. That’s what happened to Safran. After a concussion, she started experiencing neck pain along with the migraine attacks she thinks, in hindsight, she’d been having since childhood. She saw multiple providers looking for answers, she says. “I finally understood neck pain could be a symptom…two years after I was diagnosed with chronic migraine.”
This is why it can be so useful to keep track of how you are feeling, Dr. Loder says. When and why you start feeling pain is important—as well as whether you’re having any other gnarly symptoms. “How long does it take to develop?” she asks. “Are you just sitting there minding your own business and suddenly your neck is intensely painful? Or does it gradually build up?” Also, record things that aggravate your neck pain or make it better; for example, does rubbing the area help or make it worse? Dr. Loder also recommends reporting pain levels to your doc on a 0 to 10 scale, with 10 being the most painful.
Careful tracking has helped Brackett learn that neck pain is likely a symptom of her migraine rather than a possible trigger. “Now that I understand that this is an early sign of an attack, I can treat [it] sooner, increasing the chances of success,” she says. (And there are a lot of migraine treatment options if that’s the source of your trouble!)
Speak to your doctor.
You should always feel empowered to talk to your health care provider about any new or unusual symptoms you’re experiencing, but that’s especially important if neck and head pain is interfering with your life. Your primary care doctor can be a good place to start, but you can loop in other experts as needed. “Most general doctors are good at helping with these problems, but seeing a headache specialist may be helpful,” Dr. Loder says.
Your doctor will likely examine your neck to make sure you can easily move it and rule out any other conditions that could be contributing to problems in this area, like rheumatoid arthritis or a prior injury.
If you do have neck pain with migraine and your symptoms are severe, your doctor might recommend trigger point injections. These are anesthetic injections into painful muscle knots to treat myofascial pain, which affects the tissues that hold your muscles in place. Another option is a nerve block, a shot that delivers relief by blocking pain messages from the nerves in a specific area.
As for cervicogenic headache, many of the treatments your doctor suggests might be similar (nerve blocks can help with this type of pain too), though physical therapy often offers the most noticeable benefits.
Try home remedies.
Some people who experience both neck pain and migraine may find it helpful to use a hot or cold compress for 15 to 20 minutes a few times a week if the area seems to be acting up, says Dr. Sanguinetti. If you currently have a lot of neck pain and tension, you can do this multiple times a day, and then taper to two to three times a week once your symptoms start to calm down, she says.
Other strategies that can be helpful for neck pain with migraine include stretching to combat neck stiffness, some moderate daily exercise (like yoga), and over-the-counter NSAIDs when pain acts up, along with plenty of rest. Your doctor might also recommend acupuncture, prescription medications, or physical therapy.
The latter may be particularly beneficial for people with neck pain and migraine. “Physical therapy can be enormously helpful,” Dr. Loder says.
Most importantly, don’t hesitate to seek help—and push for follow-up care if your doctor’s initial recommendations aren’t working. “People should know that there are many different treatments out there and that they do not have to suffer,” Dr. Sanguinetti says.
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Originally Appeared on SELF
