Analysis of the cranio-cervical curvatures in subjects with migraine with and without neck pain

Objective: To investigate the differences in head and cervical spine alignment between subjects with migraine and healthy people.

Design: A cross-sectional, observational study.

Participants: Fifty subjects with migraine and 50 matched healthy controls.

Main outcomes measures: The presence of neck pain and neck pain-related disability was assessed. Four angles (high cervical angle, low cervical angle, atlas plane angle and cervical lordosis Cobb angle) as well as four distances (anterior translation distance, C0 to C1 distance, C2 to C7 posterior translation and hyoid triangle) were calculated using digitalised radiographs and analysed using K-Pacs^® software.

Results: Subjects with migraine reported a longer history of neck pain symptoms, and higher pain intensity and neck-pain-related disability than controls (P<0.01). Patients exhibited a smaller anterior translation distance (mean difference: 4.9mm, 95% confidence interval 1.8 to 8.8; P<0.001) and hyoid triangle (difference: 3.0mm, 95% confidence interval 1.0 to 5.0; P=0.02) than healthy controls. When the presence or the absence of neck pain was included in the analysis, the differences did not change. Differences in anterior translation and hyoid triangle distances were considered clinically relevant for subjects with migraine suffering from neck pain.

Conclusion: Subjects with migraine exhibited straightening of cervical lordosis curvature. The presence of neck pain did not influence head posture in subjects with and without migraine.