Neck and headaches indicate migraine

Headache and pain in the neck indicate migraine

31.08.2011

Anyone who complains of headaches and neck pain at the same time could suffer from a migraine headache. Although this context often occurs, it is rarely recognized on an outpatient basis, as the German Migraine and Headache Society (DMKG) explained.

Headache with at the same time pain in the neck indicates a migraine attack. Tim Jürgens, neurologist at the University Medical Center Hamburg-Eppendorf explained. In practice, this relationship is often not considered. Headaches with concomitant neck pain are caused by the trigeminal nerve, e.g. responsible for the perception of facial pain. The occipital nerve also causes discomfort. This is responsible for the care of the back of the head and the neck. If the trigeminal nerve is activated during a migraine, pain in the neck area and headache at the back of the head occur. In medical practices, however, this context is often not recognized. The result: Patients have to indulge in numerous studies, which are unnecessary and burdensome from the point of view of headache society.

„In an American study of patients with migraine, up to 50 percent suffered from nausea, a common symptom of migraine. Up to 70 percent complained of pain in the neck during their migraine attacks“, explained Jürgens, member of the DMKG. Pain in the neck area is one of the most common complaints of a migraine attack. If the attacks heaped up about three to four times a month occurs, from the perspective of the doctor, a treatment with drugs makes sense. In addition to beta-blockers, antidepressants such as amitriptyline, epileptic medications and other active ingredients such as flunarizine are then used in conventional medicine. However, drug therapy should be accompanied with exercise that increases endurance. Although relief has been achieved in most cases with sport, it is still unclear why this is so.

Unnecessary costs for the health system
If a physician determines a relationship between neck pain, the typical symptoms of migraine and headaches, and all other findings are normal, further diagnostic work-up is unnecessary in the opinion of the headache expert. Above all, the x-ray of the cervical spine or a magnetic resonance tomography of the cervical spine (cervical spine) would be superfluous here, especially since firstly patients are too insecure and secondly they are exposed to unnecessary radiation exposure. The array of diagnostic tools in this context cause the patient or the health insurance company unnecessarily high costs, which can be avoided by early detection of the problem.

Interdisciplinary diagnostics for other symptoms
However, if patients are already in their old age or suffer from pain in the neck without temporal connection with migraine, further diagnostic procedures are necessary. „Here, the close cooperation with other specialists may be necessary“, says Dr. Tim Jürgens. Behind the symptoms other diseases can be concealed. For example, patients could suffer from cervical spine wear or even an acute onset stroke. An interdisciplinary cooperation of doctors is then absolutely necessary. However, before any medical procedures on the cervical spine due to neck or head ache, a neurologist should be consulted, as the specialist emphasizes. „While surgery for acute disc herniation in the cervical spine is justified, it should be excluded that it is a conservatively treatable condition such as migraine.“

In naturopathy, further treatment options are available. In addition to the biofeedback training, successes in psychosomatic therapy, neural therapy and the already scientifically recognized Asian acupuncture treatment have already been observed. At a minimum, parallel alternative therapy may be considered. (Sb)

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