A pulsating headache, nausea, visual sensations, and light sensitivity are some of the usual symptoms that come to mind when people describe a migraine attack. However, neck pain is also quite common when having migraines. 

Many people notice neck pain before, during, or after their migraine attack. This pain does not always mean that there is an injury or structural problem going on with the neck. If you suffer from migraines, you may be wondering why this type of pain happens.

This article will explain the connection between migraines and neck pain, what that means for you, and when it is time to seek medical care. It will also go over some of the most common treatment options and how you can get evaluated with a neurologist.

Is Neck Pain a Common Migraine Symptom?

Many people with migraines report neck pain that can occur before, during, after, or in between attacks. In some cases, neck pain can even be a warning sign that a migraine attack is about to occur. 

Neck pain tends to be more common with chronic migraines (in simple terms, where there are 15 or more migraine attacks per month) compared to episodic migraines (where there are 0-14 days with migraine attacks per month). However, neck pain can still occur with both types.

Although unpleasant, uncomfortable, and painful, neck pain associated with migraines does not necessarily mean that there is an injury or structural problem going on with the neck. 

How Migraines Can Cause Neck Pain

There are several processes in the body that are involved in causing migraines and neck pain. This section will go over some of these processes in the nervous system that explain how migraines can cause neck pain.

Shared Pain Pathways Between the Head and Neck

Migraines involve abnormal pain signaling in the nervous system. This means that nerves can become more sensitive and get irritated easily, causing pain. 

The nerves in the body work and connect with each other like roads connect different places in a city. Different areas of the body are supplied by different nerves. These nerves come together to certain regions, like road intersections. These regions process and send information to the brain, just like how a main highway connects smaller cities to the capital city.

Migraines and neck pain commonly occur together because the nerves that process pain in the head and neck connect through the same pathway and transmit signals to the brain. Because of this overlap, migraine pain can be felt in both the head and neck.

Muscle Tightness and Protective Tension

With migraines, muscles in the neck and shoulders can tense up, get tight, and feel stiff. This can happen subconsciously as a response to increased sensitivity to pain. Muscle stiffness and tightness in the neck and shoulders can make discomfort worse, but this is usually more so related to the migraine itself than actual injury or structural defects in the body.

Increased Sensitivity During Migraine Attacks

Because of changes in the way the brain and the rest of the nervous system normally process information, migraines can cause increased sensitivity to sensations like touch, pain, and movement. This explains how many migraine sufferers experience sensitivity to light, touch, and sound when they have a migraine attack.

As a result, common everyday body sensations like neck strain or poor posture can become more severe when having a migraine attack. This heightened sensitivity can highlight neck pain and make it feel worse and even more persistent.

Can Neck Pain Be an Early Sign of a Migraine Attack?

Neck pain can be an early sign of an upcoming migraine attack. Many people may notice symptoms like neck stiffness, soreness, discomfort, or pain before the migraine attack occurs. 

These sensations can occur hours or even a day before the actual migraine attack happens. It can be a signal that a migraine episode is upcoming. Because every person experiences migraines differently, it is important to keep track of individual triggers, warning signs, and patterns. 

Migraine, Neck Pain, and Cervical Nerves

Cervical nerves are special nerves in the neck that help transmit and coordinate sensory information between the neck and the brain. These nerves help you sense a variety of things like touch and pain. 

With migraines, these upper cervical nerves can become more sensitive and get irritated easily, which can contribute to migraine-related neck pain and other uncomfortable sensations.

This overlap between migraines and neck pain can often cause confusion with other kinds of headache disorders. As there are many types of headaches, a thorough evaluation with a neurologist or other headache specialist is essential to finding out the cause of headaches and the neck pain you experience. 

How to Tell If Neck Pain Is Migraine-Related

Migraine-related neck pain often follows certain patterns that you can recognize. You can usually identify signs such as neck pain (typically occurring on one side), light sensitivity, nausea, and a pulsating headache (also typically occurring on one side). 

These patterns for migraine-related neck pain are usually predictable across migraine attacks. Because of this, it’s important to pay attention to the duration, timing, and symptoms that happen with these episodes. Everyone experiences migraines a little bit differently, so these triggers can be very individualized.

When Neck Pain With Migraine May Be a Red Flag

Although neck pain is common with migraines, there are certain emergency migraine warning signs to watch out for that warrant evaluation as soon as possible. If you notice any of these warning signs, seek care immediately.

Some of these “red flag” signs include a sudden severe headache (that feels like the “worst headache of your life”), fever, not being able to stop vomiting, neurological changes (like slurring of speech, numbness, or weakness on one side of the body), or neck stiffness with confusion. 

In addition, new or worsening migraine symptoms should be evaluated by a specialist, instead of being ignored. Catching these signs early can help your neurologist create a better treatment plan for you. 

Treatment Approaches for Migraine With Neck Pain

Treatment for migraines with neck pain is usually focused on managing the symptoms of migraines, rather than directly treating the neck pain itself. Some treatment approaches aim to reduce the occurrence and severity of migraine attacks, while others work to treat migraines when they occur.

Common migraine treatments include medications (such as triptans, beta-blockers, non-steroidal anti-inflammatory drugs), lifestyle changes (exercise, stress management, biofeedback), physical therapy, posture adjustments, or identification and avoidance of triggers.

Treatment plans are often individualized, meaning that it is important to consult with your neurologist or other specialist to find the headache and migraine treatment plan that works best for you. 

When to See a Specialist for Migraine and Neck Pain

If you are suffering from frequent migraines and associated neck pain, you can benefit from a neurology evaluation for migraines. A neurologist is a medical doctor who specializes in conditions involving the brain and the rest of the nervous system. They are trained to treat and manage conditions like migraines and associated neck pain.

After a thorough evaluation, your neurologist can help you identify triggers and create an individualized migraine treatment plan to help you manage your symptoms and start feeling better as soon as possible.