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Managing Pain 2019

Using physiotherapy for neck pain to help manage people with migraine

Julie Sugrue

Clinical Specialist Physiotherapist at Beaumont Hospital

Physiotherapists commonly encounter people with migraine and neck pain. In fact, more than three quarters of people with migraine experience neck pain. This is due to anatomical connections between upper neck nerves, and nerves from the head and face.

The physiotherapist will ask questions about your neck pain and migraine. Similarly. they will use hands-on assessment to determine if the neck stiffness and pain may be a potential migraine trigger.

Neck pain may be one trigger of many

The treatment of migraine is unique. The physiotherapist will take into account that your neck will only ever be one trigger of many. The management of neck-related symptoms in migraine usually involves hands-on treatment and exercises. However, all other triggers and lifestyle factors such as hormonal changes, sleep patterns, stress, skipping meals, and dehydration, obesity and not exercising need to be recognised and managed for overall successful migraine management.

Keeping a migraine diary can pinpoint triggers

A physical assessment will raise the physiotherapist’s suspicion that the neck may be acting as a trigger, but it is only through a trial of treatment that the physiotherapist will be sure.

The best thing to do is to keep a detailed headache and migraine diary for at least one month before you start physiotherapy, and then to continue to record your symptoms during your treatment. If there is no significant change in the number of days you are getting headache or the severity of your symptoms, then physiotherapy is not working for you.

Focusing on lifestyle changes and medication is often an essential addition to treatment, and again a detailed diary will show the areas of management that are most beneficial.

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