woman leaning forward easing her neck pain from migraine
Chronic Migraine,  Episodic Migraine,  Migraine,  Science/Research

Why is Migraine Such A Pain In The Neck?

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I have had neck pain along with migraine for as long as I can remember. It just took me a long time to realize that the migraine neck pain in my was actually a symptom related to migraine. It was not a separate underlying condition. This was certainly complicated by the fact that I had herniated a disc at the C6-C7 area of my spine shortly after my son was born. Because of this, I really thought that the years of neck pain before and after this injury were all related, even though physical therapy was successful. Why was I still so convinced that the pain in my neck was a separate underlying condition? Simply because it wasn’t until my headache specialist explained the connection between migraine and neck pain that I became aware of the symptomology. 

Neck Pain During Migraine

More than half of all migraine patients report neck pain during their migraine attacks (Hvedstrup et al, 2019). This recent study showed that patients who experienced neck pain during their migraine attacks, also had increased pain and tenderness between attacks. Another study refers to the trigemino-cervical complex (the pathway between the trigeminal nerve which activates during migraine and the cervical area of the spine, in the neck) and how this provides a link for referred pain. (Castien & De Hertogh, 2019) Migraine activates in our brains, and we often feel the pain in our neck first. This makes it seem as if the neck pain has triggered the migraine attack. In reality, the neck pain is often the first warning sign that a migraine attack is imminent. 

I can most definitely relate to this from my own experience. Without question, my first physical pain symptom of migraine is neck pain and it can trigger anxiety about the oncoming attack. This linked blog is great about lessening anxiety. It starts at the very top of my spine, where the base of my skull meets my neck. It is almost a burning sensation at first. Gradually, I feel it connect to my eye. Even though I’m feeling it a bit right now, I find it hard to explain. There’s a knot on the right side of my neck and I know that when the migraine attack is completely gone, it will be gone as well. When I was chronic and intractable, the knot was always there and so was the neck pain. It wasn’t until I got better control over my migraine that I was able to reduce my overall neck pain. 

When To Have Neck Pain Investigated

Is neck pain always migraine related? No. Pain that radiates to your arm or tingling in the hand needs to be discussed with your doctor. The pain that I felt when I had my herniated disc in my neck was pain under my shoulder blade. It was excruciating and I was sure it was a problem with my shoulder. I never dreamed that I had a significant problem with my neck based on the pain in my shoulder. Radiating pain is not the only kind of pain that could indicate another problem. Most migraine neck pain is located towards the top of the neck. If you have intense, persistent neck pain, discuss the type and location with your doctor to see if further testing is in order.

How It Affected Me

Migraine was a near constant companion for me for 18 years. I had daily attacks during my time of chronic and intractable migraine and neck pain was constant as well. I tried many things to alleviate my neck pain, but what finally relieved the pain was defeating the chronic cycle. That was probably the first time that I truly believed my doctor that the neck pain was linked to migraine. When I finally had a break in migraine pain, the neck pain disappeared and I realized that he was right. My new goal was to figure out how to stretch those good days into even more migraine attack free days. If you haven’t read about how we approach treating migraine, check out our blog about the Treatment Pie

Even when I was having daily attacks, I could always feel my neck pain ramp up before my migraine head pain would spike. I felt like I had to protect my neck from wind and cold. Sometimes I would avoid going to my son’s baseball games or my daughter’s golf matches, if the weather was wonky. If I did go, I would dress in a way that would shield my neck from the crazy, gusting wind. If it was at all windy outside, I would avoid walking the dog or golfing on those days. The wind could trigger my neck pain on a relatively low pain day and send me to bed.  

Now That We Know About It…

It’s one thing to know and understand that neck pain is part of migraine. The next obvious question is what can we do about it? What can we do to help minimize the symptoms? We all know that having fewer migraine attacks is our ultimate goal. We have pulled together our best tips for how to treat neck pain while you are in the thick of migraine. The following lists are things you can talk to your doctor about or try at home to minimize the pain in the neck that migraine has become.  

Talk To You Doctor About:

  • Trigger Point Injections – Trigger points are smalls knots that can form in your muscles. If present in your neck, your doctor might suggest a round of these injections that consist of steroid and anesthetic. 
  • Nerve Blocks – These might be an option depending on the severity of your neck pain and your overall migraine condition. Discuss this option with your doctor.   
  • Physical Therapy – Ordered by your doctor, the physical therapist can teach you special exercises to help relax, stretch and strengthen your neck muscles. 
  • Chiropractic – Finding a practitioner who is knowledgeable with migraine is key. Many chiropractors can also advise about making changes to posture especially in the workplace. It’s important to not go down a rabbit hole with some alternative medicine providers. Our blog here talks about the importance of not chasing the root cause of migraine.
  • Massage – A knowledgable massage therapist can be helpful with neck pain as well. I was never helped much by having my trigger points released, but I know others that were. Drinking lots of water before and after massage is also key.
  • T.E.N.S. Unit – This is a Trancutaneous Electrical Nerve Stimulation Unit. There are a couple of theories for how these actually work to relieve pain. This is an option used in conjunction with physical therapy.  
  • NSAIDs or Steroids – Your doctor may recommend a short course of NSAIDs or steroids to help relieve your pain. If you have chronic migraine and you are concerned about rebound, please read this blog.

Things You Can Try At Home

  • Pure Enrichment Neck & Shoulder Heating Pad – A good heating pad can be a life saver when it comes to neck pain. This one is plush and doesn’t pill. It can wrap around your head and is wonderfully comfortable.
  • Huggaroo Neck and Shoulder Wrap – This is a microwavable heating pad with herbal aromatherapy. It offers a deep moist heat that is great for both neck and shoulder pain. An unscented version is also available.
  • Range Master – This shoulder pulley system for physical therapy exercises was great after I had rotator cuff surgery. It can also stretch your sore neck and shoulder areas associated with migraine pain.
  • Lord Jones High CBD Formula Body Lotion – I love this CBD lotion. It can help my neck feel better very quickly. I also use it on my hands during golf season. Pure gold! Unscented version available as well.
  • Primal Botanicals – Head & Neck CBD Rub – This is a wonderfully soothing balm that I love to apply to my neck when I am having migraine symptoms. I love the smell and I find it absolutely soothing. It is made by a Registered Nurse and clinical herbalist who is also a member of Migraine Strong. (Get 10% of with code STRONG10)
  • Green Goo – This is natural skin care for inflammation, joint pain, sore muscles etc. I can be very sensitive to smells and this one has a super light scent with background notes of ginger and peppermint. It is very soothing.
  • Youthlab Radiance Roller – I know. What is a beauty product doing on this list? This roller has stones on the outside that help massage the muscles of the neck and face. And it can be stored in the refrigerator to help it get extra cold. It feels wonderful on my neck and face.
  • Tennis balls – Take two tennis balls and put them in the end of a sock and tie it off tightly. Lie on your back on the floor and place the tennis balls at the base of your skull. Allow your head to rock back and forth and side to side for just a few minutes. Simple and inexpensive. This simple trick can feel so amazing when those knots in your neck are being bratty. 
  • Pilates/Yoga/Tai Chi – If you are a sloucher, practicing one of these disciplines can help you to improve your posture. They are also great forms of exercise and movement. 
  • Icy Hot – I love this stuff and it is so easy to pick up at your local story. Roll it on your neck and it lasts for hours. During a recent attack, I made the mistake of applying it and then lying on a heating pad. Not the best idea I’ve ever had. Sort of felt like shards of hot icicles were impaling my neck. Heating pad or Icy Hot…either/or, not and!!

Where To Go From Here

I hope you have some new insight into the neck pain you have been experiencing with your migraine attacks. While these tips help with daily symptoms, lasting relief can be found with better overall control of migraine symptoms. Was finding this control easy for me? Considering it took me 18 years to find what worked, I would say no. But figuring out how to reduce my overall disability from migraine by using the Treatment Pie significantly changed my life. We talk about how to use the Treatment Pie in our blogs and in our private Facebook group. If you are searching for a way to potentially reduce your overall migraine attacks, come check us out. We’d love to get to know you!!

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Why is Migraine Such A Pain In The Neck?

I began having migraine attacks when I was a teenager, but was never properly diagnosed until I was an adult. This began 18 years where I was chronic and mostly intractable, resulting in a migrainous stroke in the summer of 2014. By implementing the protocols from the Heal Your Headache book by Dr. David Buchholz and the Migraine Strong Treatment Pie, I have been able to reduce my migraine frequency to episodic and maintain that since 2015. The end result of continuing to practice these tools is being able to actively participate in my life as a wife, mother, family member and friend. My goal as a migraine advocate, educator, and wellness coach is to help others gain more control over migraine. Let us know how we can help.

One Comment

  • Maria

    This article is very timely for me. I just went to a consultation at an upper cervical chiropractor who took xrays of my neck and found a 4% misalignment in my atlas (c1). Which he says was significant and likely contributing to my constant neck pain and migraines. The treatment plan he is suggesting is incredibly expensive. I’m confused if this could be an actual cause of my pain or if I’m being persuaded as all chiros tend to do…

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