Migraines with neck pain

Updated April 17, 2017

Many migraine sufferers report neck pain that seems caused by the excruciating headache or even to be "causing" the headache itself. Stress and tension only aggravate the condition. As the neck becomes increasingly stiff and tight as the result of these episodes, it can trigger continual problems with your range of motion and ability to live a pain-free life.

The Facts

The National Institute of Neurological Disorders reports that an estimated 45 million Americans suffer from migraine headaches, even if only every few months. The pain from these headaches can not only cause extreme pain, but also be difficult to treat. Research done by David M. Biondi, DO, reports that migraine sufferers commonly have altered neck posture or reduced range of motion, and it is estimated that 64 per cent of migraine attacks involve neck pain.


Headaches with neck pain are sometimes referred to as cervicogenic headaches or muscle contraction headaches. According to research by Dr. Biondi, a cervicogenic headache is characterised by hemicraneal pain and involves the bony structures and soft tissue of the neck. A muscle contraction headache is sometimes less severe, and can be caused by contraction of the neck and head muscles. Stress and tension are both contributors to these types of migraines and neck pain. These headaches may also be brought on by an injury to the head or neck area that was not treated adequately---or at all---with physiotherapy. As a result, muscles can become weakened, making them more susceptible to tension and stress.


Diagnosis is made by a neurologist, who will ask a series of questions about the types, number and severity of you headaches. When neck pain is reported, diseases such as meningitis need to be ruled out. Laboratory evaluations are necessary to rule out any systemic diseases that may be adversely affecting the muscles and joints. Tests such as a CT (CAT scan) or MRI (magnetic resonance imaging) may be used to determine if there may be something more serious involved, such as a brain tumour. Zygapophyseal joint, cervical nerve, or medial branch blockades ---tests done in a clinical setting---are used to confirm the diagnosis of cervicogenic headache, and help the neurologist determine which treatment options are best.

Pharmacological Treatment

Many patients use pharmacological treatment to manage these headaches. Muscle relaxants such as cyclobenzaprine may be used to effectively deal with muscle contractions. Medications---including Zomig or Imitrex---are commonly prescribed to treat a migraine once it has begun. Also, other medications may be prescribed as preventives. These medications are taken daily to try to prevent or reduce the number of headaches a patient suffers from. Nortriptyline, Depakote and Propranolol are commonly prescribed to help achieve this preventive action.

Physical Treatments

Physical treatment like massage therapy or physiotherapy is helpful to some people. Others may choose to see a chiropractor to help loosen muscles and realign the body. In addition, acupuncture and acupressure are alternative treatments that many people use, and some migraine sufferers find these techniques helpful in dealing with migraine pain.


The National Institute of Neurological Disorders and Stroke reports that regular exercise can reduce the frequency and severity of migraine headaches. Performing exercises that strengthen your neck and shoulder muscles can be especially beneficial. This strengthening can be achieved through such activities as yoga, swimming or weightlifting.

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About the Author

Kristie Jernigan is a health writer with over 17 years of experience as a medical social worker. She has worked mainly with the elderly population and with children. She holds a Bachelor of Science in psychology and early childhood from East Tennessee State University and a Master of Science in health care administration and gerontology from the University of Phoenix.