What You Need To Know About Migraines And Neck Pain

Migraines are much more than headaches. These episodes are characterized by strong pulsating or thumping discomfort, usually experienced in a specific place in the head. The bouts could last between 24 and 72 hours and are preceded by uneasiness, vomiting, and light-headedness. 

In most cases, neck pain occurs alongside the migraine.

So, what is the relationship between migraine and neck pain? Does one cause the other, or is one part of the other? 

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The link between migraine and neck pain

We know a link exists between migraine and neck pain. There are pain pathways and routes that can explain the relationship between the two. 

Various anatomical components in the head and neck react to pain. These pain mechanisms differ based on the parts affected. According to recent data, migraines are caused by irregular cellular behavior and sensory neurons in the brain and nervous system, particularly the trigeminal nerve branches.

The trigeminal nerve regulates facial feelings and muscular actions, including biting and chewing. It is also strongly implicated in the majority of migraine headaches. 

When irregular electrical activity spreads across the brain, the trigeminal nerve transmits pain impulses and releases chemicals that cause inflammation in nearby blood vessels. This reaction causes the classic migraine symptoms. The trigeminal nerve’s core is located in the uppermost vertebrae of your cervical spine or neck.

Is neck pain a symptom of migraine?

Neck discomfort is typically a symptom of migraine rather than the cause. Some people experience neck pain as the initial symptom of a migraine attack well before the headache begins. Others get persistent neck discomfort when the headache subsides.

Neck discomfort is fairly prevalent at any phase of a migraine episode.

Chronic migraine sufferers may experience persistent neck pain, often on the same side as the headache. Neck pain is an overlooked part of the debilitating symptom complex that can accompany a migraine.

What is a cervicogenic headache?

Cervicogenic headaches¹ begin in the cervical spine, located in the neck. They develop when pain is directed to the head from a particular cause in the neck. 

These headaches can sometimes be mistaken for migraine headache symptoms. Cervicogenic headaches are distinct from migraine with neck pain because, unlike migraine (a primary headache), they are secondary headaches. 

Cervicogenic headache symptoms are typically side-locked, meaning they develop across one area of the neck, head, and face.

Cervicogenic headache symptoms

Cervicogenic headaches are characterized by persistent, non-throbbing pain at the base and bottom of the skull, which may extend downwards into the neck and between the shoulder blades. You may experience pain behind the brow and forehead, although the problem emanates from the cervical spine.

Other cervicogenic headache symptoms include:

  • Face or headache on one side

  • Nausea

  • Neck discomfort and stiffness

  • Eye discomfort

  • Hazy vision

  • A restricted neck range of motion

  • One-sided neck, shoulder, or arm pain

  • Head discomfort brought on by specific neck motions or postures

  • Light and noise sensitivity

What causes cervicogenic headaches?

Problems with the neck can cause cervicogenic headaches. They are frequently caused by difficulties with the cervical vertebrae located at the top of the spine, especially the C2–C3 vertebra. 

While stress or damage to the neck or spine are the most common causes of cervicogenic headaches, various additional factors might contribute to their occurrence.

Other causes of cervicogenic headaches include the following.


Whiplash is an injury to the muscles of the neck. Vigorous motion in the neck can lead to pain by damaging bones, nerves, and muscles. Fractures or other neck-related injuries can also cause discomfort.

Neck strain

Some jobs, such as driving, carpentry, hairstyling, or sitting at a computer, can strain the neck, resulting in compressed nerves and neck discomfort. This sort of pain normally subsides with rest, but it’s best to rest between tasks to reduce strain. 

People who hold their heads forward may get headaches due to the excess weight or strain on the neck. Repeated neck strain can cause chronic nerve and muscle damage in the upper spine. 

Sleeping in an uncomfortable position

If you sleep with your head in a position that strains your neck, you may develop a compressed nerve which may cause a cervicogenic headache.

The following medical disorders can also cause cervicogenic headaches.


Tumors can compress and change the form of the bones and muscles surrounding the neck. A tumor also reduces blood supply to the neck, leading to disc misalignment and painful cervicogenic headaches.

Arthritis of the upper spine

When you have arthritis in the upper spine, the nerves and bones in your neck might compress, causing pain and stiffness.


Infections, diabetes, and high blood pressure can all cause discomfort.

Treatment and management of cervicogenic headaches

Treatment for cervicogenic headaches should address the source of neck pain and may differ based on what works best for you.

Cervicogenic headache treatments include the following.


Your doctor may first recommend an over-the-counter nonsteroidal anti-inflammatory medication. If ineffectual, further pain-relieving medications may be administered. These include: 

  • Anti-epileptic drugs such as gabapentin, pregabalin, divalproex sodium, topiramate, and carbamazepine

  • NSAIDs

  • Acetaminophen

  • Muscle relaxants

Physical therapy

A structural issue in the neck is usually the cause of cervicogenic headaches, and therefore, physical therapy would be helpful. Therapeutic exercises can help alleviate neck pain caused by muscular imbalance, forward head position, and trapezius muscles. These workouts target the neck and the muscles that support it. 

You can work with a physical therapist to create personalized treatment plans. The physical therapist will determine the location of the pain during the first consultation. They may then massage the soft tissue and manipulate the joints to ease the painful sensations.

Surgery or injection

If your cervicogenic headache discomfort is serious, your doctor may recommend a procedure to protect your nerves from being crushed, although this is rare. 

Injection procedures that employ anti-inflammatory or pain-relieving drugs can typically give enough pain relief while being minimally intrusive. These processes also enable various manual and non-invasive treatment modalities to be administered in a pleasant and patient-friendly manner.

A doctor can inject pain relievers into the nerves and joints of the head and neck. These frequently give pain relief and can assist in determining the source of the discomfort.

How to prevent cervicogenic headaches

Some episodes of cervicogenic headaches are unavoidable. This is true for headaches caused by a disease such as osteoarthritis, which tends to worsen with age. 

However, most of the measures used to manage pain may also be used to alleviate these headaches. For example, you are advised to maintain proper posture when seated or standing. 

Also, avoid sleeping with your head raised on a pillow. The actual pillow type may vary depending on your sleeping posture and body type. Always try to keep your neck and spine aligned, and wear a neck brace if you’re sleeping on a couch or sitting up.

Treat a one-sided headache attentively at all times. Although uncommon, it may indicate a rupture in one of the neck arteries. Keep a record of your neck pain and other migraine signs as well

Tracking your reactions can help you identify any causes or trends in your migraine episodes. If you experience other symptoms like nausea and hazy vision while having a headache, you should seek immediate medical attention.

You can also engage a massage therapist who has experience treating neck pain migraine. They can help you relax the muscles that are causing your headache. 

When to visit a doctor?

Most headaches subside after a short period, but cervicogenic headaches may last since they are caused by musculoskeletal issues that require treatment. Consult a doctor if the pain lasts longer than 72 hours, does not go away despite over-the-counter pain relievers, or worsens.

During the medical examination, your doctor may feel/press various regions on your neck to see whether they are uncomfortable and ask you to move your neck in different ways. They may also recommend an MRI, X-ray, or a scan to provide a clear view of the head, neck, and upper spine structure. Blood tests may be needed to confirm or rule out the existence of an infection.

The lowdown

Neck pain is one of the most prevalent symptoms of migraine. If you struggle with headaches and experience migraine neck pain, taking medication will likely provide relief.

Cervicogenic headaches are secondary headaches brought on by neck problems. These can be caused by cervical vertebral abnormalities, neck traumas, inflammation, or other medical complications.

If your neck pain develops from migraine attacks, you should consult a doctor because you may be suffering from another condition. A thorough diagnosis coupled with therapy can help relieve your neck discomfort and keep it from worsening.

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