Migraine and Cervical Spine Pain: Understanding the Link

Migraines are more than “just headaches.” For many patients, migraine attacks are deeply connected to neck pain, stiffness, and dysfunction in the cervical spine. In fact, the neck and head share overlapping nerves, muscles, and pain pathways—making cervical spine issues a common but often overlooked contributor to migraine symptoms.

Understanding the connection between migraines and cervical spine pain can open the door to more effective, targeted treatment strategies.

How the Cervical Spine Is Linked to Migraine

The upper cervical spine (C1–C3) plays a critical role in head movement, posture, and nerve signaling. Nerves from this region converge with trigeminal nerve pathways in the brainstem—an area heavily involved in migraine processing.

When cervical joints, muscles, or discs become irritated or dysfunctional, they can trigger or amplify migraine pain through shared neural pathways.

Common Cervical Spine Issues That May Trigger Migraines

• Poor posture or forward head position
• Cervical facet joint irritation or arthritis
• Muscle tension or myofascial trigger points
• Whiplash or prior neck injury
• Cervical disc degeneration or bulging discs

These conditions can lead to referred pain into the head, often mimicking or worsening migraine symptoms.

How Cervicogenic Pain Differs From Migraine — and Why They Overlap

Cervicogenic headaches originate from the neck, while migraines are considered a neurological disorder. However, many patients experience both simultaneously.

Signs that cervical spine pain may be contributing include:

• Migraines that start in the neck or base of the skull
• Pain worsened by neck movement or sustained posture
• One-sided head pain linked to neck stiffness
• Reduced range of motion in the cervical spine

Treating only the migraine without addressing the neck can limit symptom relief.

Evaluation: Looking Beyond the Head

A comprehensive evaluation should assess both neurological and musculoskeletal factors. This may include:

• Cervical spine examination and range-of-motion testing
• Postural assessment
• Diagnostic imaging when appropriate
• Targeted diagnostic injections to identify pain generators

Organizations such as the American Migraine Foundation emphasize the importance of identifying co-existing musculoskeletal contributors to migraine symptoms.

Treatment Options That Address Both Migraine and Neck Pain

Conservative Therapies

• Physical therapy focused on cervical stabilization
• Postural retraining and ergonomic adjustments
• Manual therapy and soft-tissue techniques

Interventional Options

• Cervical facet joint injections
• Trigger point injections
• Occipital nerve blocks
• Radiofrequency ablation for chronic facet-mediated pain

Comprehensive Care

• Coordinated migraine management with cervical spine treatment
• Lifestyle modifications such as sleep optimization and stress reduction

When to Seek Specialized Care

If migraines persist despite medication, or if neck pain consistently accompanies migraine attacks, it may be time to explore a cervical spine evaluation. Treating the underlying musculoskeletal contributors can be a key missing piece in long-term migraine relief.

Final Thoughts

Migraines and cervical spine pain are closely connected through shared anatomy and nerve pathways. Recognizing this relationship allows for more precise diagnosis and more effective, individualized treatment plans—especially for patients who feel stuck in a cycle of recurring migraines.