Individual perceptions on the relationship between migraine and neck pain

Background: Despite neck pain being a common complaint for people with migraine, little is known about how individuals perceive the relationship between their migraine and neck pain. Exploring their beliefs and perceptions could provide valuable understanding to improve overall management and reduce the burden of migraine and neck pain.Objectives: To investigate individual perspectives on how migraine and neck pain relate.Methods: A retrospective qualitative study was performed. Seventy participants (mean age 39.2, 60 female) were recruited via community and social media advertisements, and interviewed by an experienced physiotherapist using a semi-structured interview framework. An Inductive thematic analysis was used to analyse the responses.Results: Five themes were identified from the interviews: (i) the timing of neck pain and migraine, (ii) causality beliefs, (iii) burden of neck pain and migraine, (iv) experiences with treatment and (v) mismatched perspectives. Diverse views emerged, revealing links between the first two themes of timing and causality, showing increased burden in those suffering from both neck pain and migraine, and providing insights into apparently ineffective or even aggravating treatments.Conclusions: Valuable insights for clinicians emerged. Due to the complex relationship, clinicians should discuss the aetiology of neck pain in migraine with patients. For some individuals, neck treatment may not produce longterm relief and may even aggravate migraine, but the value of short-term relief in a chronic condition must be considered individually. Clinicians are ideally placed to have discussions with patients individually to tailor individual decisions about management.