The Study On The Comorbidity Of Primary Headache And Neck Pain

BackgroundPrimary headaches are common neurological disorders. Migraine and tension type headache are more prevalent than other primary headaches. According to the studies in foreign countries, neck pain is more common in the people with primary headache than that in the ordinary people. However, there is no data on the prevalence of neck pain in Chinese people with primary headache. To date, few studies focused on the issue that how to prevent from neck pain for people with primary headaches. Besides, it was reported that neck pain could occur during the acute migraine. But the mechanism and the potential implications on treatment remain unknown.ObjectiveTo investigate the prevalence of neck pain and its risk factors in Chinese people with primary headache. We hope to provide the potential implications on the migraine treatment through exploring the mechanism on the neck pain during the acute migraine.MethodsConsecutive patients with primary headache were enrolled from International Headache Center of PLA general hospital. The demographics and data were recorded through a semi-construction interview. At the same time, Episodic migraineurs were enrolled and allocated to 3 groups:group 1= migraineurs didn't have neck pain; group 2= migraineurs suffered from neck pain but the neck pain was not the accompaniment of acute migraine; group 3-migraineurs suffered from neck pain which could be the concomitant symptoms of acute migraine. The sex-and age-matched healthy controls who did not report headache or neck pain were enrolled. The muscle tenderness scores and neck pain disability were recorded in the all participants during the headache free period.ResultsThe one year prevalence of neck pain in 158 migraineurs (mean age:37.23 years old, F:128.81%) was 59.5% and that in 167 patients with tension type headache (mean age 40.34 F:95,57%) was 51.5%. For migraineurs. age (OR:1.04,95% CI:1.01-1.09 p=0.04) and mobile phone use (OR:1.28,95% CI:1.05-1.56 p=0.02) might be the risk factors for neck pain. For people with tension type headache, age (OR:1.06,95% CI:1.02-1.12 p<0.01), gender (OR:5.16,95% CI:1.75-15.28 p<0.01), the frequency of headache (OR:1.06,95% CI:1.01-1.12 p=0.02), drinking (OR:3.90,95% CI: 1.32-11.52 p=0.01) and becoming chronic tension type headache (OR:4.51,95% CI: 1.10-18.38 p=0.04) might be the risk factors for neck pain.There was no significant difference (p=0.93) in cranio-cervical muscle tenderness between healthy controls and migraineurs without neck pain (group 1) during the headache free period. The migraineurs who reported neck pain could occur during the migraine phase (group 3) had the relatively higher neck disability and muscle tenderness than other migraineurs (group 1 and group 2). Compared to the patients in without neck pain (group 1), the ones with neck pain in group 2 (p<0.01) and group 3. (p<0.01) had higher muscle tenderness scores. The muscle tenderness scores positively correlated to neck pain disability index.Conclusion1. In China, neck pain is highly prevalent in the people with primary headache2. For migraineurs, the increasing time of using mobile phones may increase the risk of neck pain3. For people with tension type headache, the increasing frequency of headache and chronic headache may increase the risk of neck pain.4. The correlation between the neck pain and acute migraine may have the potential implications on the cervical therapy for migraineurs.