Migraine Treatment Delayed by Neck Pain

by Teri Robert, Lead Expert,

A 2010 study showed that neck pain is more common as a symptom of Migraine than nausea.2 (See Neck Pain as a Migraine Symptom.) Now researchers are finding that when a Migraineur has neck pain, Migraine treatment is often delayed.1

The study

Study objectives:

"This study will examine whether presence of neck pain is associated with a delay in Migraine treatment. Background: We have previously shown that neck pain is exceedingly common in Migraine. We have further shown that its presence on the day preceding Migraine is associated with impaired treatment response, and that neck pain is predictive of Migraine-related disability independent of headache frequency and severity."2

Study methods:

  • Prospective participants were examined by Migraine and headache specialists to confirm diagnosis of Migraine and exclude both cervicogenic headache and fibromyalgia.
  • 113 participants kept a detailed diary for at least one month and until six Migraine had been treated.
  • Participants treated their Migraines at the stage during which they usually treated.
  • Researchers performed the chi-square test of independence to examine the relationship between presence of neck pain and treaing the Migraines within 30 minutes of onset.*

Study results:

  • Study participants recorded 2,411 "headache" days
  • 786 of the 2,411 headaches were Migraines
  • There was complete data for 749 Migraine attacks, the majority of which were treated in the moderate pain stage.
  • Presence of neck pain in the hour preceding initial Migraine treatment was associated with delay in treatment beyond 30 minutes of onset.
  • When neck pain accompanied Migraine, participants who experienced moderate or severe neck pain were more likely to treat within 30 minutes of headache onset than those with mild neck pain.

Study conclusions:

"In this study, presence of neck pain was associated with delayed treatment of Migraine, as indicated both by a higher pain burden at the time of initial treatment and by longer wait times before treatment initiation. The authors speculate that this delay may have several explanations. One is that Migraineurs simply fail to relate neck pain to Migraine attacks. Beyond this, the authors believe that neck pain is so prevalent in Migraine—particularly as it undergoes chronification—that Migraineurs are inured to its presence and therefore ignore neck pain until it increases in severity or until headache pain intensity surpasses it."

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