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. 2021 May;15(2):199-212.
doi: 10.1177/2049463720924704. Epub 2020 May 31.

Involvement of cervical disability in migraine: a literature review

Naoki Aoyama  1
Affiliations

Involvement of cervical disability in migraine: a literature review

Naoki Aoyama. Br J Pain. 2021 May.

Abstract

Background: The trigeminal nerve theory has been proposed as a pathophysiological mechanism of migraine; however, its association with the triggers of migraine remains unclear. Cervical disability such as neck pain and restricted cervical rotation, have been associated with not only cervicogenic headaches but also migraine. The presence of cervical disability could worsen of the migraine, and also the response to pharmacologic treatment may be reduced. The aim in this review is to highlight the involvement of cervical disability in migraine, considering contributing factors.

Findings: In recent years, evidence of neck pain complaints in migraine has been increasing. In addition, there is some recent evidence of cervical musculoskeletal impairments in migraine, as detected by physical assessment. However, the main question of whether neck pain or an associated cervical disability can act as an initial factor leading to migraine attacks still remains. Daily life imposes heavy loads on cervical structures (i.e. muscles, joints and ligaments), for instance, in the forward head position. The repetitive nociceptive stimulation initiating those cervical skeletal muscle positions may amplify the susceptibility to central migraine and contribute to chronicity via the trigeminal cervical complex.

Conclusion: Further studies are needed to explain the association between cervical disability as a source of pain and the development of migraine. However, evidence suggests that cervical disability needs to be considered in the prevention and treatment of migraine.

Keywords: cervical disability; migraine; neck pain; trigeminal cervical complex.

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Conflict of interest statement

Conflict of interest: The author declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart for the identification of studies.
Figure 2.
Figure 2.
Schema of a possible migraine mechanism.
See this image and copyright information in PMC

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