It’s estimated that about 38 million American adults suffer from migraines and nine-in-ten report that to some degree, migraines affect their ability to carry out their normal social, leisure, work, and everyday activities. Unfortunately, there isn’t a one-size-fits-all treatment for migraines as the condition is not well understood and management tends to focus on lifestyle modifications to avoid potential triggers for a patient’s particular migraine profile. But what if a potential key to managing migraines wasn’t in the head at all? What if the neck had a role to play in migraine headaches?
A 2015 study found that 87% of chronic migraine headache patients also have neck pain. Compared with the non-headache sufferers the researchers questioned, individuals with migraines were roughly three-to-four times more likely to have neck pain. To highlight this relationship between the neck and migraines, a 2023 study looked at 295 migraine patients and found that more than half (51.9%) also had concurrent neck pain. Further analysis showed that migraine sufferers with concurrent neck pain reported more severe migraine symptoms, and the more disabling their neck pain, the worse their migraines. This makes some sense as the trigeminal nerve, which helps innervate the face and has been linked to migraines, exits the spinal cord through the upper cervical spine and travels into the face. In addition to irritation of the trigeminal nerve having a part to play in the migraine process, previous studies have identified a link between migraines and impaired cervical range of motion, reduced neck muscle endurance, and the presence of trigger points in the neck muscles.
The good news is that doctors of chiropractic have a number of tools in their treatment repertoire for addressing these issues: spinal manipulation, mobilization, myofascial release, and other manual therapies to dry needling, neck-specific exercise, postural training, dietary recommendations, and more. It all depends on the patient’s unique presentation. This approach appears to be effective, as demonstrated in a recent three-armed trial that compared spinal manipulative therapy, sham manual treatment, and usual medical care after a three-month treatment period with follow-ups at three, six, and twelve months. The results favored chiropractic care at all time points. A systematic review of 13 studies published in 2022 concluded that mobilization techniques, trigger point therapy, manual lymphatic drainage, massage, and stretching techniques are each effective interventions for migraine headache patients, especially when used in combination. Other studies have demonstrated that addressing trigger points in the neck and other disorders in the cervical spine can result in reduced frequency, intensity, and duration of migraine episodes.
While managing migraines may require a comprehensive approach that includes exercise, diet, and lifestyle modifications, it’s clear that disorders of the neck can contribute to, if not be an underlying cause of, migraines and should be addressed. If you suffer from migraines, especially if you also have neck pain or stiffness, consult your doctor of chiropractic.