Musculoskeletal neck pain in patients with migraine: pathophysiological relationship, diagnosis and treatment

Musculoskeletal neck pain (NP) is more common in people with headaches (HA) than in those without HA. NP is most frequently associated with primary forms of HA. In real-world clinical practice, patients with NP and concomitant HA are often misdiagnosed, with HA being regarded as secondary and associated with organic pathology of the cervical spine. Consequently, such patients often do not receive effective treatment, or the treatment provided has only a temporary effect. We present the case of a female patient with migraine and NP. A combined approach was used to treat the patient, comprising a course of a non-steroidal anti-inflammatory drug (Nimesil) and non-pharmacological therapy – educational discussions with the patient about the condition, individual kinesiotherapy sessions, kinesiotaping, training in ergonomic principles and correct posture, and physical activity in daily life. After 2 months of treatment, the patient’s musculoskeletal pain and headaches associated with cervical myofascial pain syndrome had resolved; only rare migraine attacks remained, which were effectively relieved by a triptan. Follow-up of the patient over a 12-month period demonstrated the sustainability of the clinical improvement achieved, confirming the effectiveness of the described therapeutic approach in the treatment of musculoskeletal neck pain and associated migraine.