• Posted November 29, 2023

Could the Neck Be to Blame for Common Headaches?

WEDNESDAY, Nov. 29, 2023 (Healthday News) -- Your neck muscles could be giving you headaches, claims new German research that used special MRI scans to spot the connection.

“Our imaging approach provides [the] first objective evidence for the very frequent involvement of the neck muscles in primary headaches, such as neck pain in migraine or tension-type headache, using the ability to quantify subtle inflammation within muscles,” said researcher Dr. Nico Sollmann. He's with the Department of Diagnostic and Interventional Neuroradiology at University Hospital Rechts der Isar in Munich.

People with tension-type headaches often feel a tightening in the head and mild to moderate dull pain on both sides of the head. On the other hand, migraines are characterized by a severe throbbing pain that generally strikes one side of the head. Migraines may also cause nausea, weakness and light sensitivity.

Neck pain is commonly associated with primary headaches, but until now there have been no biomarkers to measure neck muscle inflammation and irritation.

In the study, Sollmann's team zeroed in on the involvement of the trapezius neck muscles in primary headaches using a special type of MRI to look for links between neck pain frequency and headaches. The researchers measured muscle pain and irritation using something called muscle T2 values.

The prospective study included 50 participants, mostly women, ranging in age from 20 to 31. Sixteen had tension-type headache, while 12 had tension-type headache plus migraines. The groups were matched with 22 healthy controls.

All participants had a 3D turbo spin-echo MRI. Associations between muscle T2 values and the presence of neck pain, number of days with headache and number of pain points as determined by manual manipulation of the trapezius muscles were analyzed.

The tension-type headache plus migraine group demonstrated the highest muscle T2 values. In turn, higher muscle T2 values were significantly associated with the number of headache days and the presence of neck pain.

The findings were to be presented Wednesday at the annual meeting of the Radiological Society of North America (RSNA). Such research is considered preliminary until published in a peer-reviewed journal.

“The quantified inflammatory changes of neck muscles significantly correlate with the number of days lived with headache and the presence of subjectively perceived neck pain,” Sollmann said in an RSNA news release. “Those changes allow us to differentiate between healthy individuals and patients suffering from primary headaches.”

Muscle T2 mapping could also be used to stratify patients with primary headaches and to monitor treatment effects.

“Our findings support the role of neck muscles in the pathophysiology of primary headaches,” Sollmann said. “Therefore, treatments that target the neck muscles could lead to a simultaneous relief of neck pain, as well as headache.”

Sollmann also noted that noninvasive treatments that target pain in the neck muscles could be as effective and safer than medications.

“Our imaging approach with delivery of an objective biomarker could facilitate therapy monitoring and patient selection for certain treatments in the near future,” he added.

More information

Visit Johns Hopkins Medicine for more on headaches.

SOURCE: Radiological Society of North America, news release, Nov. 29, 2023