Are cervical muscles involved in migraine and tension-type headache pathogenesis? A review

Abstract

Migraine and tension-type headache (TTH) physiopathology is still unclear and controversial. According to researches, there is an association between these primary headaches and musculoskeletal dysfunctions of deep and superficial cervical flexor muscles. Therefore, it is possible to suspect that these structural and behavioral muscles dysfunction are associated with migraine and CTT pathogenesis, causing some changes in head and neck biomechanics, as well as limitations in cervical mobility. Thus, the need for more information required a review of more relevant studies to clarify the role of neck muscles in migraine and CTT pathogenesis, in order to support and direct the nonpharmacological treatment of patients with headache and muscular disorders. The Pubmed, Cochrane and Bireme databases were searched, between January/2012 and June/ 2013, using the keywords: 'migraine disorders', 'tension-type headache', 'neck muscles', 'ultrasound', 'electromyography'. The selection identified 73 articles, of which 8 were excluded according to the eligibility criteria. Evidences suggest the existence of a cause and effect relationship between cervical structures and migrainous and TTH pain, indicating that both peripheral and central mechanisms of sensitization are involved. However, most of these studies are based on experimental animal models, which have different painprocessing systems from humans. Furthermore, the methodological aspects decrease the strength of evidence found in their results.