Neck Pain as a Migraine Symptom

Patient Expert

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We often think of nausea as a symptom of a Migraine attack. In fact, the International Headache Society lists nausea as one of the defining symptoms of Migraine.2

Researchers recently published the results of a study to look at the prevalence of neck pain in Migraine.

The Study

Study objective:

"To determine the prevalence of neck pain at the time of migraine treatment relative to the prevalence of nausea, a defining associated symptom of migraine."1

Study methods:

  • Participants were chosen from a university headache and Migraine clinic and from the general population.
  • Potential participants with fibromyalgia, cervicogenic headaches, or history of cervical trauma or surgery were excluded.
  • A total of 234 participants were confirmed as eligible for the study.
  • Participants entered details of their Migraines in a daily diary for at least one month and until six Migraines had been treated.
  • Of the 234 eligible participants, 113 turned in completed study diaries. Those who did not complete diaries were excluded.
  • Data from the diaries was analyzed to compare the frequency of neck pain and nausea.

Study results:

  • Participants recorded 2,411 headache days, 786 of which were Migraine days.
  • The majority of the Migraines were treated in the moderate pain stage.
  • Regardless of the stage at which the Migraine was treated, neck pain was more prevalent than nausea.
  • Neck pain was also more prevalent than nausea regardless of the intensity of headache pain.
  • The prevalence of both neck pain and nausea directly correlated with Migraine frequency in participants with fewer than 23 Migraine days a month. For those with 23 or more Migraine days a month, the correlation was substantially weakened.

Study conclusion:

"Neck pain is a common and integral feature of migraine. In this sample of Migraineurs, neck pain was more commonly associated with migraine than was nausea, one of the defining characteristics of the disorder. Greater awareness of neck pain as an associated symptom of migraine may improve diagnostic accuracy and have a beneficial impact on time to treatment.."1

Summary and comments

This study found neck pain to be a "common and integral" symptom of Migraine. Since nausea has been so widely published an discussed as a symptom of Migraine, indeed even listed in the International Headache Society's ICHD-II, it's somewhat surprising that the study found neck pain to be more common during Migraine than nausea.

The study also confirms anecdotal evidence from Migraineurs who frequently speak of neck pain as a symptom of Migraine.


1 Calhoun, Anne H., MD; Ford, Sutapa, PhD; Millen, Cori, DO; Finkel, Alan G., MD; Truong, Young, PhD; Nie, Yonghong, MS. "The Prevalence of Neck Pain in Migraine." Headache. Published Online: Jan. 20, 2010.

2 The International Headache Society. "The International Classification of Headache Disorders, 2nd Edition (ICHD-II), 1st revision." Cephalalgia 2005; 25.

Medical review by John Claude Krusz, PhD, MD

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