The Link Between Migraines and Neck Pain

Neck pain and migraine sometimes go hand-in-hand.

It can be tough to know whether your neck pain is a symptom of a migraine headache or if it is a trigger.

To further muddle things, neck pain can also occur with other types of headaches. 

Don’t let any confusion over this matter cause headache pain.

We’ll break everything down in this article. First, we’ll first discuss if neck pain is a symptom or a trigger of migraine headaches.

Then, we’ll talk about cervicogenic headaches (headaches originating from the neck) and tension headaches.

After that, we’ll explain how sleep and posture play a role in neck pain and migraines, treatments for migraine neck pain, and when to see a doctor about neck pain with or without a migraine headache.

Is Neck Pain a Symptom of a Migraine?

While not every migraine causes neck pain, this symptom is commonly associated with migraine headaches, particularly chronic migraines. 

Other symptoms of a migraine

Migraines have four stages, although not everyone experiences all four phases every time they have a migraine headache.

Each stage has different symptoms.

• Prodrome: This pre-migraine phase may start anywhere from a few hours to 3 days before a migraine. Symptoms may include excessive yawning, mood changes, food cravings, neck pain, gastrointestinal changes, and increased urge to urinate.

• Aura: Approximately 25% of migraine patients experience aura, the second phase. This can start before a migraine or happen at the same time. Aura symptoms include disturbances to vision (flickering lights, bright lines, blind spots), sounds (tinnitus, other noises), and other senses (numbness, tingling, pins and needles).

• Attack: The attack phase is when head pain starts. The pain is focused on one side of the head and may also occur behind the eyes. Migraine pain can feel throbbing, stabbing, pulsing, or pounding. It can worsen with movement, light, sounds, or smells. The attack phase may last from a few hours to 3 days. Other symptoms include nausea, vomiting, neck pain, and sleep problems.

• Postdrome: Sometimes referred to as a “migraine hangover”, this last phase is after the head pain ends. It may last a few hours to a few days. Symptoms include fatigue, dizziness, weakness, and muscle aches.

Is Neck Pain a Trigger or Symptom of Migraines?

While neck pain can appear before, during, or after a migraine, neck pain is a symptom, not a trigger. 

What the research says

In one small study, researchers used EMG (electromyography) testing to assess the neck muscles of 102 individuals.

Those who experience migraines did not have neck pain that involved actual neck muscle dysfunction or tension, which suggests that the pain isn’t a trigger.

The researchers conclude that perceived neck pain is a subjective experience and is a symptom of a migraine attack. 

Cervicogenic Headaches

The neck is medically referred to as the cervical spine.

When a headache is caused by pain or problems with the neck, it is called a cervicogenic headache. 

Migraines are a different headache type.

They are considered to be primary headaches because the pain isn’t related to another medical issue.

Cervicogenic headaches are secondary headaches because the head pain is a secondary symptom of neck pain or injury.

Cervicogenic headaches can be caused by many things, including:

• Fractured vertebrae
• Pinched nerve
• Infection
• Osteoarthritis 
• Rheumatoid arthritis
• Muscle strain
• Tumor

Cervicogenic headaches may have similar symptoms to migraines, including pain on one side of the head.

However, they do not typically cause nausea, vomiting, visual disturbances, or other signs of aura.

The primary symptom of a cervicogenic headache is a stiff neck and reduced range of motion.

Neck Pain and Tension Headaches

Tension-type headaches (TTH) are the most common type of headache.

They are caused by many things, including:

• Scalp muscle tension
• Neck muscle tension
• Stress
• Depression
• Anxiety
• Head injury
• Hunching over a desk, computer, or smartphone
• Alcohol use
• Tobacco use
• Sudden change in caffeine intake (too much or too little)
• Sinus infections
• Jaw clenching
• Teeth grinding
• Fatigue

Tension headaches are different from migraines.

While migraine pain is typically felt on one side of the head, tension headaches feel like dull pressure or pain spread all over the head or neck.

The Role of Sleep and Posture

Sleeping in a position that strains the head, neck, shoulders, or back can lead to headaches.

Migraines

Compared to other types of headaches, sleeping in a strange position is less likely to cause a migraine.

Still, sleep is important for preventing migraines.

Too little or too much sleep can be a trigger. 

Headaches

Many people spend most of their day hunched over a computer or phone.

Focusing on sitting and standing with good posture may help prevent headaches and alleviate other types of muscle tension and discomfort.

Neck pain

Depending on the type of neck pain you have, sleeping with a special pillow designed for optimal head and neck support may help prevent cervicogenic headaches, neck pain, and general muscle tension.

Treatments for Migraine Neck Pain

Neck pain compounds the misery of migraines.

Luckily, some treatments may help ease this discomfort.

• Trigger point injections: Trigger points are areas where muscles tense up in response to stimuli (such as migraine or injury) and are unable to relax. Trigger point injections using local anesthetic and sometimes steroid medication may help resolve a trigger point and address neck pain in migraine. 

• Occipital nerve blocks: For worse migraine neck pain or for people who have chronic migraines, occipital nerve blocks may be more effective. These injections include longer-acting anesthetics and steroids to help resolve inflammation in the area. The effects can last for weeks to months.

• Botox injections: Though not a typical first-line migraine medication due to their cost, Botox injections are one type of migraine treatment that may also help address neck pain.

Physical therapy

If neck pain is a recurring problem, physical therapy may help.

It can strengthen neck muscles, lead to better flexibility, and address muscle stiffness.

Physical therapists can also suggest ways to improve posture that may contribute to neck problems.

Medications

The same medicines used to treat other migraine symptoms can also be effective for addressing migraine neck pain. These include:

• OTC painkillers such as acetaminophen (Tylenol), naproxen (Aleve), aspirin, ibuprofen (Advil, Motrin), and Excedrin.

• Preventive medications like anticonvulsants and certain antidepressants.

• Prescription pain relievers such as triptans, anti-nausea drugs, dihydroergotamine, and less commonly, opioids.

When to See a Doctor

If you have severe neck pain, with or without migraines, see your healthcare provider.

An accurate diagnosis can ensure that you receive effective treatment.

While taking over-the-counter medications like painkillers can help, if you find that you frequently deal with migraines, neck pain, or both, you may benefit from medical care and more targeted therapies.

If you are not sure what is normal for headaches or neck pain, a healthcare provider can help you understand your symptoms.

How K Health Can Help

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