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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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European Journal of Physical and Rehabilitation Medicine 2017 June;53(3):342-50

DOI: 10.23736/S1973-9087.17.04393-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Musculoskeletal disorders of the upper cervical spine in women with episodic or chronic migraine

Gabriela N. FERRACINI 1, Lidiane L. FLORENCIO 2, Fabíola DACH 1, Débora BEVILAQUA GROSSI 2, María PALACIOS-CEÑA 3, Carlos ORDÁS-BANDERA 4, Thais C. CHAVES 1, José G. SPECIALI 1, César FERNÁNDEZ-de-las-PEÑAS 3

1 Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, FMRP-USP, Ribeirão Preto, São Paulo, Brazil; 2 Departament of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Faculty of Medicine of Ribeirão Preto, University of São Paulo, FMRP-USP, Ribeirão Preto, São Paulo, Brazil; 3 Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Alcorcón, Spain; 4 Department of Neurology, Hospital Rey Juan Carlos, Móstoles, Spain


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BACKGROUND: The role of musculoskeletal disorders of the cervical spine in migraine is under debate.
AIM: To investigate differences in musculoskeletal impairments of the neck including active global and upper cervical spine mobility, the presence of symptomatic upper cervical spine joints, cervicocephalic kinesthesia and head/neck posture between women with episodic migraine, chronic migraine, and controls.
DESIGN: A cross-sectional study.
SETTING: Tertiary university-based hospital.
POPULATION: Fifty-five women with episodic migraine, 16 with chronic migraine, and 22 matched healthy women.
METHODS: Active cervical range of motion, upper cervical spine mobility (i.e., flexion-rotation test), referred pain from upper cervical joints, cervicocephalic kinesthesia (joint position sense error test, JPSE), and head/neck posture (i.e. the cranio-vertebral and cervical lordosis angles) were assessed by an assessor blinded to the subject’s condition.
RESULTS: Women with migraine showed reduced cervical rotation than healthy women (P=0.012). No differences between episodic and chronic migraine were found in cervical mobility. Significant differences for flexion-rotation test were also reported, suggesting that upper cervical spine mobility was restricted in both migraine groups (P<0.001). Referred pain elicited on manual examination of the upper cervical spine mimicking pain symptoms was present in 50% of migraineurs. No differences were observed on the frequency of symptomatic upper cervical joints between episodic and chronic migraine. No differences on JPSE or posture were found among groups (P>0.121).
CONCLUSIONS: Women with migraine exhibit musculoskeletal impairments of the upper cervical spine expressed as restricted cervical rotation, decreased upper cervical rotation, and the presence of symptomatic upper cervical joints. No differences were found between episodic or chronic migraine.
CLINICAL REHABILITATION IMPACT: Identification treatment of the musculoskeletal impairments of the cervical spine may help to clinician for better management of patients with migraine.


KEY WORDS: Migraine disorders - Range of motion, articular - Posture - Neck

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Publication History

Issue published online: June 15, 2017
Article first published online: January 24, 2017
Manuscript accepted: January 19, 2017
Manuscript revised: January 13, 2017
Manuscript received: June 29, 2016

Cite this article as

Ferracini GN, Florencio LL, Dach F, Bevilaqua Grossi D, Palacios-Ceña M, Ordás-Bandera C, et al. Musculoskeletal disorders of the upper cervical spine in women with episodic or chronic migraine. Eur J Phys Rehabil Med 2017;53:342-50. DOI: 10.23736/S1973-9087.17.04393-3

Corresponding author e-mail

cesarfdlp@yahoo.es