Migraines & Neck Pain: Understanding the Connection

Find out how migraines and neck pain can disrupt your day and explore solutions to help you regain your comfort and peace.

Introduction

As a Nurse Practitioner with over 20 years of experience in physical and functional medicine, I’ve seen firsthand how chronic migraines—especially those linked with neck pain—can derail lives. Migraines are more than just severe headaches; they are complex neurological events often triggered by musculoskeletal dysfunction, stress, inflammation, and poor posture.

What’s often overlooked in traditional care models is the close relationship between cervical spine health and migraine activity. By integrating chiropractic care, postural retraining, and functional nutrition, we can significantly reduce migraine frequency and severity for many patients.

In this comprehensive post, we’ll explore:

• The anatomical and physiological link between neck pain and migraines
• The role of fibromyalgia in exacerbating migraine symptoms
• Evidence-based chiropractic interventions
• Postural and ergonomic corrections
• Anti-inflammatory nutritional strategies

The Link Between Neck Pain and Migraines: Cervicogenic and Neurovascular Overlap

Patients often describe their migraine episodes beginning with a deep ache or stiffness in the neck, which gradually radiates toward the skull. This isn’t coincidental—it’s anatomical. Many migraines are cervicogenic in origin, meaning they arise from dysfunctions in the cervical spine.

The Cervical Trigeminovascular Connection

Cervicogenic headaches and migraines share overlapping pathways, particularly involving the trigeminocervical complex—a convergence of sensory nerves from the cervical spine and trigeminal nerve that transmits head and facial pain. Misalignment, muscular tension, or inflammation in this area can trigger the trigeminal-autonomic reflex, activating symptoms like:

• Throbbing head pain
• Light and sound sensitivity
• Visual aura
• Nausea

According to Vicente et al. (2023), activation of this reflex and extracranial autonomic involvement may underlie migraine generation when cervical structures are compromised. This suggests that structural or functional issues in the neck—such as joint hypomobility or myofascial tension—can act as primary migraine triggers.

Common Migraine-Associated Neck Pain Triggers

• Cervical spine misalignment
• Postural kyphosis and forward head posture
• Muscular tension from occupational strain or emotional stress
• TMJ dysfunction
• Inadequate sleep or poor sleep posture

Fibromyalgia: An Amplifier of Migraines and Neck Pain

Patients with fibromyalgia are particularly susceptible to migraines due to central sensitization—a phenomenon in which the central nervous system becomes hypersensitive to stimuli.

In these patients, mitochondrial dysfunction plays a key role. As Janssen et al. (2021) highlight, both fibromyalgia and migraines are associated with impaired cellular energy metabolism. Symptoms in fibromyalgia patients often include:

• Intensified migraine episodes
• Musculoskeletal tenderness in the neck, trapezius, and occiput
• Sleep disturbances and fatigue
• Amplified pain response to touch (allodynia)

Understanding this connection allows for more targeted and effective treatment plans. Interventions must address not just musculoskeletal alignment but also systemic inflammation and nervous system regulation.

Tension Headaches Explained- Video

Holistic and Functional Interventions for Migraine Management

1. Chiropractic Care and Manual Therapy: Restoring Cervical Balance

Chiropractic interventions can be transformative for patients experiencing migraines related to neck dysfunction. Techniques such as cervical spine manipulation, soft tissue release, and muscle energy techniques (METs) help restore balance and reduce pain signaling.

Key Chiropractic Techniques:

• Suboccipital Release: Alleviates deep muscle tension that compresses the greater occipital nerve
• Cervical Mobilization: Increases joint range of motion and reduces localized inflammation
• Myofascial Release: Targets the tight fascia and deep muscle layers in the upper back and neck
• Instrument-Assisted Soft Tissue Mobilization (IASTM): Enhances blood flow and breaks down fibrotic tissue

Research by Mayo & Keating (2023) demonstrates that chiropractic spinal manipulation can significantly reduce migraine frequency and symptom duration, especially when combined with ergonomic education and exercise.

2. Postural Retraining and Ergonomics: Reducing Structural Strain

Modern lifestyle habits, such as prolonged screen use and poor workstation design, contribute significantly to cervical dysfunction and subsequent migraines.

Postural Interventions:

• Craniocervical Flexion Exercises: Strengthen deep neck flexors and reduce forward head posture
• Scapular Stabilization Routines: Reinforce shoulder and thoracic posture
• Workstation Ergonomic Adjustments: Monitor elevation, lumbar support, and keyboard positioning

A 2021 study by de Almeida Tolentino et al. confirms that correcting head and neck posture can significantly reduce the frequency of migraines and improve functional disability scores in migraine sufferers.

3. Anti-Inflammatory Nutrition: Healing from Within

Nutritional strategies play a crucial role in modulating inflammation and stabilizing the nervous system. Many patients experience relief by identifying and avoiding dietary migraine triggers such as:

• Aged cheeses
• Processed meats (high in nitrates)
• MSG, aspartame, and high-sugar foods
• Alcohol, especially red wine

Functional Nutrition Recommendations:

• Elimination Diets: Help identify food triggers and reduce systemic inflammation (Gazerani, 2020)
• Magnesium Supplementation: Reduces cortical spreading depression and improves vascular tone (Shin et al., 2020)
• Omega-3 Fatty Acids: Found in fatty fish, flaxseed, and chia, these combat neuroinflammation
• Riboflavin (Vitamin B2): Shown to reduce the frequency of migraines when taken consistently
• CoQ10: Improves mitochondrial function and energy production in the brain

Integrating these supplements and dietary shifts can offer long-term, sustainable relief by addressing underlying metabolic and neurological dysfunctions.

Integrated Care Planning: The Functional Medicine Model

In my clinical practice, treating migraines associated with neck pain involves more than adjusting the spine or prescribing a supplement—it requires a systems-based approach.

A Sample Care Plan May Include:

• Initial chiropractic assessment and spinal X-rays (if indicated)
• Trigger point mapping and musculoskeletal evaluation
• Nutritional intake analysis with elimination diet guidance
• Prescription of cervical mobility and posture exercises
• Functional labs to assess inflammatory markers and micronutrient status
• Co-management with neurologists for medication tapering (when appropriate)

The goal is to transition patients from episodic crisis management to proactive wellness, reducing reliance on pharmaceuticals and emergency interventions.

Empowering Patients Through Education and Collaboration

One of the most rewarding aspects of integrative care is educating patients about how their lifestyle, posture, diet, and spinal alignment interact to affect migraine frequency and severity.

By understanding the why behind their symptoms, patients are more empowered to:

• Recognize and avoid migraine triggers
• Adhere to treatment protocols
• Participate in preventive strategies like exercise and stress reduction

When patients are viewed not just as symptoms but as whole individuals, outcomes dramatically improve. As we tailor care to their unique physiology and environment, we foster long-term healing—not just temporary relief.

Conclusion: Migraines and Neck Pain—An Opportunity for Functional Healing

The connection between migraines and neck pain is more than coincidental—it’s a deeply interwoven neurovascular and musculoskeletal relationship. As functional and physical medicine providers, we have the opportunity to address this relationship holistically.

Through chiropractic care, ergonomic corrections, anti-inflammatory nutrition, and nervous system regulation, we can guide patients toward a life with fewer migraines, improved neck mobility, and greater vitality.

By looking beyond the head and acknowledging the role of the cervical spine and systemic health, we not only reduce pain—we restore function, purpose, and quality of life.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with neck pain associated with migraines. When asking important questions to our associated medical providers, we advise patients to incorporate numerous techniques to reduce migraines from reappearing and causing neck pain. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Aguilar-Shea, A. L., Membrilla Md, J. A., & Diaz-de-Teran, J. (2022). Migraine review for general practice. Aten Primaria, 54(2), 102208. https://doi.org/10.1016/j.aprim.2021.102208

Al Khalili, Y., Ly, N., & Murphy, P. B. (2025). Cervicogenic Headache. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/29939639

de Almeida Tolentino, G., Lima Florencio, L., Ferreira Pinheiro, C., Dach, F., Fernandez-de-Las-Penas, C., & Bevilaqua-Grossi, D. (2021). Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial. BMC Neurol, 21(1), 249. https://doi.org/10.1186/s12883-021-02290-w

Di Antonio, S., Arendt-Nielsen, L., & Castaldo, M. (2023). Cervical musculoskeletal impairments and pain sensitivity in migraine patients. Musculoskelet Sci Pract, 66, 102817. https://doi.org/10.1016/j.msksp.2023.102817

Gazerani, P. (2020). Migraine and Diet. Nutrients, 12(6). https://doi.org/10.3390/nu12061658

Janssen, L. P., Medeiros, L. F., Souza, A., & Silva, J. D. (2021). Fibromyalgia: A Review of Related Polymorphisms and Clinical Relevance. An Acad Bras Cienc, 93(suppl 4), e20210618. https://doi.org/10.1590/0001-3765202120210618

Jara Silva, C. E., Joseph, A. M., Khatib, M., Knafo, J., Karas, M., Krupa, K., Rivera, B., Macia, A., Madhu, B., McMillan, M., Burtch, J., Quinonez, J., Albert, T., & Khanna, D. (2022). Osteopathic Manipulative Treatment and the Management of Headaches: A Scoping Review. Cureus, 14(8), e27830. https://doi.org/10.7759/cureus.27830

Mayo, Z., & Keating, C. (2023). Manual Therapy and Exercise for the Management of Chronic Neck Pain With Multiple Neurovascular Comorbidities: A Case Report. Cureus, 15(3), e36961. https://doi.org/10.7759/cureus.36961

Shin, H. J., Na, H. S., & Do, S. H. (2020). Magnesium and Pain. Nutrients, 12(8). https://doi.org/10.3390/nu12082184

Vicente, B. N., Oliveira, R., Martins, I. P., & Gil-Gouveia, R. (2023). Cranial Autonomic Symptoms and Neck Pain in Differential Diagnosis of Migraine. Diagnostics (Basel), 13(4). https://doi.org/10.3390/diagnostics13040590

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