Great question! A neck ache before, during or after a headache episode is incredibly common and there's a good explanation for that, one that helps answer the question of how to get lasting headache relief! This post gives you a short insight into that.
Now keep in mind that here at Headache Proof, we don't fall for quick fixes or gimmicks and tend to be a bit nerdy when it comes to backing up what we talk about with research. We'll try and keep in low jargon and easy to understand for you but if you're unsure, just ask away below or throw the question up as a thread on our new forum. Also, more on this and a heap more are within our free starter guide you get when you subscribe + in depth in our new book.
Is a neck ache with headaches normal?
80% of patients with a migraine also get neck pain before, during or after, which is a huge proportion and there’s a good reason for this.
Now a quick bit of info on pain and sensation in general. All of what we feel, whether it be pressure, pain, tension, fatigue etc, gets sent up as a signal to our brain to interpret. Before it gets to your central nervous system, it's just an electrical signal up your nerves. Once it gets to your brain, it can then interpret it as the a feeling depending on where it comes form and the strength of the signal, as well as what you brain expects to feel, among other things.
Now back to headaches and neck aches. Your upper neck uses the same part of our brain stem to process information as our cranial nerves do (which are the nerves that carry sensation from your head and face).(18, 19) The wiring that sends information from our neck, crosses over and is processed with the wiring (nerve) that carries the information from our head, making them very much interlinked.
Quick fact: Getting neck pain is also actually related to worse symptoms for a headache and is thought to even decrease the effect of medication (20).
There has been a lot of research carried out in the past, investigating musculoskeletal issues specifically in those with headaches, resulting in some great tests for clinicians like myself to easily and quickly test for upper neck dysfunction but they have also found very common issues what most with migraines and headaches have. These studies and particularly a recent international consensus (21) have shown that long term headache sufferers typically have more than muscle trigger points than normal, less neck range of motion, pain more easily reproduced and importantly, less neck extensor muscle strength compared to health, headache-free people. Another recent meta analysis showed that there is clearly a difference in neck range of motion, upper neck rotation, pain thresholds and forward head posture in those with migraines vs control (those without).(22)
The research is very clear that there is a solid link between your neck and your headaches. This not only is backed up by our nerve anatomy but is a pathway we can utilize to make lasting change for the better!
How this can help us Relieve Headaches
This is so damn important to understand. The research is clear that those with chronic head pain get neck pain at the same time. Further to this it’s then been investigated and found that, yes, those with headaches also have clearly reduced range, lower strength and lowered pain thresholds.
Now, tell me, will any medication fix or make change to this? Will changing and reducing what you do, in order to avoid triggering headaches change this? Will passive treatments like acupuncture, massage or self treatment tools improve and regain your neck mobility and strength long term?
Without addressing these deficits, you are always going to more easily get overloaded and feel head pain. Based on the research and my clinical experience, there’s a bloody good chance that you have weaker neck muscles, which we can also call head muscles as they don’t just move your neck! Having less strength and endurance anywhere in our body, ankle, low back, hammies and more means those muscles are going to get tired faster, not handle as much and then what happens? We feel pain. Just like if you have thigh muscles that aren’t up to the task of the running , or hiking you want to do or the stairs at work and what happens - knee pain!
It’s all well and good reducing pain and feeling better in the short term and a part of your rehab plan addresses this but if we don’t also work on improving your strength and range of motion, building better overall mobility and resilience, you’ll still be stuck in the same old cycle.
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