QUESTION: To explore the experience of neck pain (NP) among people with episodic migraine (EM) across migraine phases. NP has been documented as a migraine symptom that is associated with increased disability. However, there are limited data on the experience of NP from the perspective of individuals with migraine.
METHODS: A targeted PubMed literature review evaluated the relationship between NP and EM. Adults with clinician-diagnosed EM (5-14 days/month) were recruited to participate in concept elicitation interviews. Trained researchers used a semi-structured interview guide based on findings from the literature review. Open-ended questions were asked to elicit spontaneous reports of the NP experience associated with migraine and its temporal occurrence. Targeted questions were used if concepts were not raised spontaneously.
RESULTS: Findings from the literature review demonstrated that NP is highly prevalent before, during, and after the headache phase of migraine and was associated with increased Neck Disability Index score. Twenty participants completed the qualitative interviews; 13 (65.0%) reported NP related to migraine (pre-headache [n=12]; during headache [n=13]; post-headache [n=6]). Duration of NP ranged from a few hours to 1 day. NP was reported as the most bothersome symptom by 2 (10.0%) participants. Most participants described their NP as “tense,” “stiff,” or “tight” (n=8; 61.5%); others described their NP as a “dull ache” (n=4; 30.8%), a “kink” or “pulled muscle” (n=3; 23.1%), “sore” (n=2; 15.4%), or a “shooting pain” (n=1; 7.7%).
CONCLUSIONS: Most participants reported NP associated with migraine. NP occurred before, during, and/or after the headache phase, and was predominantly described as “tense,” “stiff,” or “tight.” These results confirm that NP is a bothersome symptom for individuals with EM and may be an important outcome of effective treatment.
