The relationship between the biomechanical features of the cervical spine and migraine
https://doi.org/10.33667/2078-5631-2026-2-55-61
Abstract
Background. Migraine frequently co-occurs with neck pain, but biomechanical impairments of the cervical spine in this phenotype remain underexplored.
Objective. To assess the relationship between cervical spine biomechanical characteristics and clinical manifestations in patients with migraine and unilateral headache.
Materials and methods. This cross-sectional study included 54 patients with verified migraine (77.8% women, mean age 33.2 years). Clinical assessment (neck pain, pain provocation, psychoemotional factors) and goniometry of active cervical movements (flexion, extension, lateroflexion, rotation) were performed.
Results. Mobility restrictions were found in 50% of patients, predominantly in rotation. Neck pain, headache provocation by neck movements, and side concordance correlated with rotation restriction (r=0.323–0.398; p<0.05). Autonomic symptoms and psychoemotional factors showed no significant associations with mobility. Shoulder girdle asymmetry was significantly more frequent in patients with movement restriction (χ²=34.9, p><0.001; OR=156).><0.05). Autonomic symptoms and psychoemotional factors showed no significant associations with mobility. Shoulder girdle asymmetry was significantly more frequent in patients with movement restriction (χ²=34.9, p<0.001; OR=156).
Conclusions. Half of patients with migraine and unilateral headache exhibit a distinct cervical mechanical component characterized by rotation restriction associated with neck pain and its provocation. Assessment of rotation and shoulder position may help identify a subgroup that could benefit from physical rehabilitation.
About the Authors
M. V. Naprienko
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Naprienko Margarita V., Dr Med Sci (habil.), professor at Dept of Sports Medicine and Medical Rehabilitation
Moscow
L. A. Zharashueva
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Zharashueva Leyla A., 1st year resident-postgraduate student
Moscow
L. V. Smekalkina
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Smekalkina Larisa V., Dr Med Sci (habil.), professor at Dept of Sports Medicine and Medical Rehabilitation
Moscow
V. A. Maskaev
N. I. Pirogov Russian National Research Medical University (Pirogov University)
Russian Federation
Russian Federation
Maskaev Vladislav A., 6th year student at Faculty of Pediatrics
Moscow
References
1. Al-Khazali H.M., Younis S., Al-Sayegh Z. et al. Prevalence of neck pain in migraine: a systematic review and meta-analysis. Cephalalgia. 2022; (7): 663–673. https://doi.org/10.1177/03331024221083608
2. Ashina S., Bendtsen L., Lyngberg A.C. et al. Prevalence of neck pain in migraine and tension-type headache: a population study. Cephalalgia. 2015; (3): 211–219. https://doi.org/10.1177/0333102414535110
3. Bartsch T., Goadsby P.J. The trigeminocervical complex and migraine: current concepts and synthesis. Curr Pain Headache Rep. 2003; (5): 371–376. https://doi.org/10.1007/s11916-003-0038-9
4. Bartsch T., Goadsby P.J. Increased responses in trigeminocervical nociceptive neurons to cervical input after stimulation of the dura mater. Brain. 2003; (8): 1801–1813. https://doi.org/10.1093/brain/awg190
5. Di Antonio S., Arendt-Nielsen L., Ponzano M. et al. Cervical musculoskeletal impairments in the 4 phases of the migraine cycle in episodic migraine patients. Cephalalgia. 2022; (9): 827–845. https://doi.org/10.1177/03331024221093236
6. Liang Z., Galea O., Thomas L. et al. Cervical musculoskeletal impairments in migraine and tension type headache: a systematic review and meta-analysis. Musculoskelet Sci Pract. 2019; (42): 67–83. https://doi.org/10.1016/j.msksp.2019.04.005
7. Szikszay T. M., Hoenick S., von Korn K. et al. Which examination tests detect differences in cervical musculoskeletal impairments in people with migraine? A systematic review and meta-analysis. Phys Ther. 2019; (5): 549–569. https://doi.org/10.1093/ptj/pzz012
8. Luedtke K., Starke W., May A. Musculoskeletal dysfunction in migraine patients. Cephalalgia. 2018; (5): 865–875. https://doi.org/10.1177/0333102417716934
9. Florencio L.L., de Oliveira A.S., Carvalho G.F. et al. Cervical muscle strength and muscle coactivation during isometric contractions in patients with migraine: a cross-sectional study. Headache. 2015; (10): 1312–1322. https://doi.org/10.1111/head.12656
10. Florencio L.L., Ferracini G.N., Chaves T.C. et al. Active trigger points in the cervical musculature determine the altered activation of superficial neck and extensor muscles in women with migraine. Clin J Pain. 2017; (3): 238–245. https://doi.org/10.1097/AJP.0000000000000396
11. Bragatto M.M., Bevilaqua-Grossi D., Benatto M.T. et al. Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? Cephalalgia. 2019; (12): 1500–1508. https://doi.org/10.1177/0333102419856608
12. Luedtke K., May A. Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine. J Headache Pain. 2017; (1): 97. https://doi.org/10.1186/s10194-017-0804-1
13. La Touche R., García-Pastor T., Reina-Varona A. et al. General physical impairments in migraine patients beyond cervical function. Sci Rep. 2024; (1): 30916. https://doi.org/10.1038/s41598-024-30916-3
14. Madsen B. K., Søgaard K., Andersen L. L. et al. Efficacy of strength training on tension-type headache: a randomised controlled study. Cephalalgia. 2018; (6): 1071–1080. https://doi.org/10.1177/0333102417736994
15. Jull G.A., O’Leary S.P., Falla D.L. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther. 2008; (7): 525–533. https://doi.org/10.1016/j.jmpt.2008.08.003
16. Lipton R.B., Dodick D., Sadovsky R. et al. A self-administered screener for migraine in primary care: The ID Migraine validation study. Neurology. 2003; (3): 375–382. https://doi.org/10.1212/01.WNL.0000078940.53438.83
17. Embaby E., Khalil A.A., Mansour A. et al. The relationship between myofascial trigger points sensitivity, cervical postural abnormality, and clinical tension-type headache parameters. J Man Manip Ther. 2024; (4): 390–399. https://doi.org/10.1080/10669817.2023.2245703
18. Do T. P., Heldarskard G. F., Kolding L. T. et al. Myofascial trigger points in migraine and tension-type headache. J Headache Pain. 2018; (1): 84. https://doi.org/10.1186/s10194-018-0903-8
19. Di Antonio S., Arendt-Nielsen L., Ponzano M. et al. Profiling migraine patients according to clinical and psychophysical characteristics. Neurol Sci. 2024; (3): 1185–1200. https://doi.org/10.1007/s10072-023-07049-2
20. Ashina S., Bendtsen L., Burstein R. et al. Pain sensitivity in relation to frequency of migraine and tension-type headache with or without coexistent neck pain. Scand J Pain. 2022; (1): 76–87. https://doi.org/10.1515/sjpain-2021-0097
21. Rasmussen-Barr E., Halvorsen M., Bohman T. et al. Effects of different exercise types in chronic neck pain: a systematic review. BMC Musculoskelet Disord. 2023; (1): 806. https://doi.org/10.1186/s12891-023-06806-7
22. Liang Z., Thomas L., Jull G. et al. Cervical musculoskeletal impairments in migraine. Arch Physiother. 2021; (1): 27. https://doi.org/10.1186/s40945-021-00115-6
23. Onan D., Martelletti P. Does the intensity of the headache differ according to the level of neck disability in chronic migraine patients? Int J Environ Res Public Health. 2022; (23): 16307. https://doi.org/10.3390/ijerph192316307
24. Castien R., De Hertogh W. A neuroscience perspective of physical treatment of headache and neck pain. Front Neurol. 2019; (10): 276. https://doi.org/10.3389/fneur.2019.00276
25. Lampl C., Rudolph M., Deligianni C. I. et al. Neck pain in episodic migraine: premonitory symptom or part of the attack? J Headache Pain. 2015; (566): 1–6. https://doi.org/10.1186/s10194-015-0566-0
Review
For citations:
Naprienko M.V., Zharashueva L.A., Smekalkina L.V., Maskaev V.A. The relationship between the biomechanical features of the cervical spine and migraine. Medical alphabet. 2026;(2):55-61. (In Russ.) https://doi.org/10.33667/2078-5631-2026-2-55-61
Views:
125
JATS XML
Email this article 