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Neck pain and migraine

Hi All,

Someone posted here the other day (couldn’t find the post) that they thought their migraine activity was because of tight neck muscles or some structural problem in the neck and nothing more (something along those lines). I wanted to comment here that this is a potential BIG RED HERRING where people will often think that they have some physiological problem in the structure of their neck being the sole “cause” /trigger of their migraine. This comes up often in other forums, one in particular for example where NUCCA (a form of chiropractic) is promoted as the fix for these sorts of dizzy problems we experience.

Here’s my take on this and what you’ll also find in the literature:

  1. Migraine very commonly causes neck pain in a migraineur. It can be excruciating if the trigger load is high. I know myself as I’ve been there and can trigger an episode easily by simply eating the wrong foods or using a particular product. If you look at the recent notes from Nick Silver he says the following:

“We recognise that migraine pain is commonest in the head, face and neck, and indeed
the pain may appear to start in the neck leading to a misperception that there is a
neck disorder
rather than a primary problem with the brain accounting for the cause
of the attack.”

  1. What I have found personally is that if neck tension and tightened muscles in the neck resulting from migraine attacks are continuous over time and nothing is done to ease the pressure (e.g. massage) that this in itself can act as a strong trigger for more migraine activity. It’s a positive feedback loop. So initially the migraine activity causes the neck pain and tension but over time it can cause the neck joints to lose mobility and then the pain caused by this new problem triggers yet more migraine and more neck pain. It becomes a downward spiral.

For case number two I wasted thousands of dollars on chiropractic care years ago before I realised that it was NOT a structural issue as the chiro insisted. Instead, it was migraine setting me off. To undo the chronic jammed up cervical spine I went for just TWO sessions of physiotherapy (just 100 bucks). She showed me how to stop the jamming up from reoccurring with home stretches and massage I can do myself. It has NEVER returned again and of course I have to avoid migraine triggers to reduce neck pain. I still get neck pain but the nasty stuff that doesn’t budge has gone for good.

Anyway, after reading Nick Silver’s new article and remembering what was said in another thread, I thought this was worth revisiting.

I’d love to hear anyone else’s thoughts on this.

Cheers … Scott 8)

Isn’t this whole MAV thing a pain in the neck?

:lol:

When my husband snuck off to see a chiropractor due to some back pain (announcing to the guy, “my wife thinks you guys are quacks” which is maybe a little too strong…), and came home after the first session and “fessed up,” I warned him to keep the guy away from his neck. My husband had already done that, but for a different reason than mine (he’s touchy when strangers get near his neck, but I don’t care what reason he gave, as long as he told him to steer clear). There’s a small but real risk of stroke from neck manipulation.

I think there’s some cranial woo thing that may have been mentioned recently. Whether it’s the wrenching of our necks by the chiro people or gentle laying on of hands to get in touch with our spinal energy fields, they’ll be happy to take our money if they can convince us we don’t have a migraine brain but something in our neck that they can fix for a fee.

Maryalice,

You know when you think about it, migraine is the PERFECT ailment for quacks and charlatans to make their money on. Very few really know exactly what’s going on, migraine creates all sorts of weird and hard-to-pin-down symptoms, and it can send you on wild goose chases, for example, thinking that there is structural problems in your neck requiring a lifetime commitment and thousands of dollars to chiropractic care. And then there’s all the people pushing VMS as a cure all. Never ends. Just have a look at the Meniere’s forum … everything from homeopathy and NUCCA to hyper-dosing on vitamin C. :roll:

Scott 8)

Hi Scott,

Having had many full blown migraines that go on for days in the past and then a few years of keeping them at a low ebb I can honestly say that the migraine causes the neck pain (with me anyway and a friend of mine). While my migraines were low I had no neck pain. Have just come back from Majorca holiday and you guessed it (what happens every time I go abroad on holiday, midweek I get a stinker of a migraine and it doesnt leave me till a week after I get home), in the throws of it now and my neck has been excruciating, throbbing, really painful.

Years ago, I spent a fortune on chiropractics and osteopaths thinking it just had to be my neck that was causing the migraine but it wasnt and I know, that when, please God this nasty continuous migraine goes, my neck pain will go also.

Christine

Hi Scott,

This is really interesting, because for a year or so I was convinced that my constant neck tightness and aches and pain could be the cause of my 24/7 dizziness. I had even read about someone who found a fix for their dizziness from a physio in Yorkshire - although I know now that this patient didn’t have MAV. Anyway, I went so far as to call this physio, and she was very helpful, and put me in touch with a great physio in Greenwich, London, who absolutely worked wonders for my neck - it felt so loose and free of tension and aches. However, gradually, the neck ache would return, despite me doing the stretches, etc. And since being on the Topamax, this ‘aching neck’ symptom has all but completely disappeared - I have an occasional ‘attack’ and I can feel the MAV activity in the head and upper neck region, but generally my neck ache has completely gone - all proof that my neck ache was MAV induced all along!

Tony.

I was wondering if people get pain right down into their shoulders as well as in the neck? I’ve always been able to see an association between shoulder and neck pain and my migraines, and I tend to get migraines come in spells, as it seems to be a vicious circle, the more my head hurts, the worse my neck/shoulder is and the worse it makes my headaches. I too have always tended to to think the neck/shoulder thing was the cause, but now I do wonder from reading Scott’s comments if it’s actually a combination of what Scott has set out in 1) and 2). My other reason for feeling that this might be correct is that I’ve just cut out all my migraine prophylatic medication about three or four weeks ago, and during this time - although my MAV hasn’t returned - my headache migraines have returned with a vengence along with neck/shoulder pain. So now I wonder if maybe the migraine meds were helping prevent the neck problems too? I went to a physio last week and had a massage and got some exercises to do, but if anything I am slightly worse ten days later. Not really sure what to do. I think I may have to think about going back onto medication again, as it’s really starting to impact on my quality of life again (though not so had as having MAV vertigo, so I am not complaining too much about it).

Hi Beech,

I’d bet the farm that your neck pain is migraine-induced. Two weeks ago, for example, I decided to try a mocha coffee – one of those stove top ones with freshly ground beans that my Italian roommate has. It tasted sensational of course but brain disagreed. I went to bed that night feeling less than average but nothing too nasty. When I woke in the morning it was as though I had pinched a nerve on the right side of my neck and shoulders. I could not turn my head to the right at all yet I had done nothing “physical” to cause this. I knew it was the coffee. I drank tons of water that day and within 36 hours and a clean diet it vanished - POOF! I could have sworn it was as though I had been lifting 100 kg weights that pulled something apart in there but it was all migraine.

This is the madness of migraine. It’s the great chameleon and mimics so many other problems leading people on wild and expensive goose chases. From chronic fatigue, to fibromyalgia, to “neck pathology” and it can all be because of migraine. There’s a girl I work with here who is a classic migraineur (but not MAV) and will be off for days at a time because of a “pulled neck muscle or pinched nerve” as she calls it. What she doesn’t get is that she’s migraining. I’m sending her Nick Silver’s latest article after I post this.

BTW, another new symptom I have from this that has emerged over the last 2 years now is acute back pain. Just like the sudden pulled shoulder feeling I can suddenly wake in the morning with a sore lower back. Again if I stay clean again, it vanishes just as fast as it arrived.

I guess the good news is that when you finally understand what’s behind it all and that you have some control over it, it no longer stresses me out as it did 10 years ago.

S 8)

This is a very interesting discussion, but also sort of maddening. I DO have back problems from scoliosis (mild) and TMJ (very bad). BUT I’m also positive that I’ve had back and neck problems from migraine - although (and here’s the confounder) I also think very back neck/back pain can trigger migraine symptoms or migraine ‘like’ symptoms as well.

There is one instance when I know for sure my horrific coathaner neck pain was migraine. On holiday in Argentina - had been very sick after travelling a long and windy road through the Andes (including blinding sun and altitude). I got really sick with what I thought at the time was a stomach bug but was actually abdominal migraine (I’ve had it since, I know). I also had severe derealisation and the general death feeling. For several days I was bed bound. On arrival at my next destination I got the hideous neck pain. To try and treat that I took a couple of Valium and had a nap. The neck pain and ALL the other symptoms went away after I woke up.

We are prima donna thouroughbreds indeed. We just need to sit still and live like monks (or nuns).

Well, when I was younger my migraine pain was in my head. Now it’s all in my neck, upper back, chest, shoulder, down arm and into hand. I would get these “spells” which I thought for sure were angina attacks. After a battery of tests and seeing a cardiologist my doctor insisted that I had the heart of a teenager - still couldnt explain this pain. It went on for years. When I saw the migraine specialist in August he said that it was my migraine pain! Instead of the head now, it was in the other extremeties mentioned. Just the brain nerves or whatever hitting a different part of the hypothelmus (sp?). I call it the hippopotamus - lol!

Anyway, I used to think the stiff neck/neck pain caused the migraines but now I’m sure my migraines are causing the neck pain! Now, if I could just get this med weight gain under control!!

Hi…I always thought the migraine caused the head and neck pain. My pain extends down to my shoulders too. I was using a chiropractor and would feel pretty good for a few days after but once my husband started giving me head and neck massages and it felt just as good if not better…I realize I don’t need to spend the money! Nothing helps the dizziness though except taking a .25 mg xanax and I don’t like to do that too often. This sucks! Take care,

Karen

Think I might cancel my physio appointment for Monday and just save myself a few quid! I have the exercises to do, and to be honest after ten days I am seeing no benefit at all, it just seems to come and go by itself regardless of what I am doing (which is probably more evidence it’s migraine rather than muscular).

Hi Beech,

I’d keep that physio up your sleeve if the pain becomes more entrenched, in other words if you feel it has caused secondary problems such as joint immobility and thus more pain and discomfort.

I usually start my day with my head face down between two pillows and gently rock the cervical spine like my physio showed me to keep them all loosened up. It’s so far prevented a major relapse of intractable pain for 18 months now. It used to completely seize up frequently before the preventative approach.

Can you go or a light massage to ease the tension in there and save a few bucks?

Hi Scott,

Yes, I think I will keep the appointment as it happens. I had an awful night’s sleep, every time I woke up due to the pain. It’s not too bad once I get up and get moving, it seems to be being still that’s the problem. The weird thing is that it was on my left side, but now that side is fine and now it’s on the right side. What?! How can it change sides?! It’s also worse on this side, as it’s radiating down my arm as well now, feels rather like sciatica does when I get that, so it must be agravating a nerve, I think.

But yes, in the future, I do wonder if some light/relaxing massage might do the trick.

Beech, it makes me wonder if we are all more sensitive to nerve pain. It would be interesting to know how many of us have nerve pain. I have loads of nerve pain in the coccyx area, which goes down my legs to the ankles sometimes. I used to get terrible neuralgia in the jaw region and in the back of the head when I got migraine. If my neck is playing up, I will ge the familiar tingling there as well. Like Victoria, I have a low back problem anyway and the scoliosis, but in all, nothing dramatically wrong. Its like we need something to dampen down the nerves :?

Scott, which way do you rock :shock: Seriously, I got a book “6 weeks to a healthy back” (that was 25 years ago, still got the bad back!).

Christine

Hi Christine,

Thanks for your input. Nerve pain is pretty common really, as are migraines, so it could just be coincidence, but like you say it would be interesting to see if being prone to migraines does make you more prone to nerve-related problems. I know I have a really poor tolerance for pain, but of course it’s impossible to know if I genuinely have a poor tolerance or whether I feel things more acutely than some other people do.

I just had my first experience with nerve pain from the back of my skull down to my neck I ended up in the ER because I was in so much pain they said there not sure if it was from some type of migraine or some type of occipital nerve pain associated with migraine just what I need on top of everything else. It’s the worst pain I have ever felt thus far in this awful disease brought me to my knees.

I have terrible neck pain and I get a massage from my chiropractors once a week. I get dizzier after the massage for a few hours, but that always goes away.

I always find myself cracking my neck to relieve the built up pressure - do any of you have that same issue?

This was one very helpfull post for me! Thanks to you all!

Dr Silver’s paper says that one of the things migraine does is:

“Amplification of normal bodily sensations”

…so since pain is a normal sensation, we would of course experience an intense variety of it. So when we get pain in our neck, or get the “coat hanger” deal (I’ve had that neck + shoulders thing), of course our muscles will feel like we’ve been in an Olympic weight lifting competition.

:roll:

Some of the time our pain may be directly caused by migraine, sometimes it may be due to working in the garden, poor posture while sitting too long at a desk, cradling the phone against the shoulder for a long time, etc. But even if it started from something else, once we start having some migraine stuff coming on, it will take that neck pain and run with it, making it much worse than it would have been otherwise.

The initiating post pretty much sums it up for me.

Must admit reading this, or any old thread down, I do wonder how all those posters are doing now. Helen