Neck pain linked to headaches

A growing body of research is examining the connection between neck pain and headaches, including migraines and tension headaches. Studies suggest that the neck and head are closely linked in terms of pain signals and inflammation.

MRI reveals muscle changes

A study published in the Journal of Headache and Pain used magnetic resonance imaging (MRI) to evaluate the involvement of the myofascial structure, including the trapezius muscle, in tension headaches and migraines among 50 participants. The study found subtle changes in the trapezius muscle that could result from inflammation.

MRI findings need caution

Mark Green, a professor of neurology, acknowledges the link between neck pain and headaches but cautions that MRI findings cannot definitively indicate inflammation, as the muscle could be tense or contracted. A separate study published in Neurology indicates a high prevalence of cervical pain before, during, and after the onset of a migraine.

Neck pain and the trigeminal nerve

Jessica Ailani, a professor of clinical neurology, notes that people who suffer from migraines often have neck pain, even outside of migraine attacks. The trigeminal nerve, which is the fifth and largest cranial nerve, is a common denominator for several types of headaches. It emerges from the brainstem and descends toward the cervical spine, transmitting signals associated with pain, touch, and temperature.

Pain sensitivity and chronic headaches

A phenomenon of pain sensitivity may also be at play, with chronic pain leading to a lower pain perception threshold. A study in the Scandinavian Journal of Pain found that people with chronic migraine or tension headaches showed increased sensitivity in the pericranial area compared to those with episodic headaches.

Trigger points and pain amplification

Myofascial trigger points in the neck or scalp can also activate headaches when pressed or subjected to physical activity. A study associates the presence of these trigger points with a reduced pain perception threshold, suggesting a sensitization effect of the pain system.

Warning signs of serious conditions

Neck pain accompanying headaches can serve as an alarm signal if accompanied by symptoms such as chills, fever, coordination or balance disorders, difficulty walking, or radiating pain or tingling in the arms or legs, which may indicate conditions such as tumors or meningitis.

Non-drug treatments recommended

In the absence of such alarming symptoms, treating both neck pain and headaches is recommended to prevent their mutual triggering. Non-drug therapies such as massage, acupuncture, stretching, and heat or cold application can help relieve neck pain. Ergonomic adjustments and supportive pillows are also recommended.

Medications and their risks

Medications such as paracetamol or ibuprofen can help combat the onset of neck pain, tension headaches, or migraines, but overuse can lead to medication overuse headaches, the most common secondary headache according to the World Health Organization. Antidepressants and anticonvulsants may be used off-label to prevent headaches.

Preventive treatment advised

Preventive treatment is recommended for frequent headaches to break the pain cycle between the neck and the head. Treatments may include repetitive peripheral magnetic stimulation (rPMS) and Botox injections, which have shown effectiveness in reducing headache days and disability in those with chronic migraine and severe neck pain.