title: Neck pain disability is related to the frequency of migraine attacks: a cross-sectional study.
abstract: BACKGROUND
  Migraine and neck pain can be critical causes of disability. The contribution of neck pain for the overall disability of individuals with migraine remains unknown.
  
  
  OBJECTIVE
  To contrast the disability experienced by individuals with episodic and chronic migraine with and without neck pain as captured by the Neck Disability Index.
  
  
  METHODS
  Disability due to neck pain was assessed using the Neck Disability Index in individuals with episodic or chronic migraine seen at a university-based headache center. Neck disability was defined as mild (score ranging from 5 to 14 points), moderate (15-24 points), severe (25-34 points) or complete (35 points or higher). To compare differences between groups, a chi-square test was applied. Log-binomial logistic regression was used to estimate disability as a function of headache status after adjustments for age, time since migraine onset, and headache intensity.
  
  
  RESULTS
  Sample consisted of 169 individuals, 104 with episodic migraine and 65 with chronic migraine. Any disability due to neck pain happened in 69% of those with episodic migraine, relative to 92% in chronic migraine (P < .001). Individuals with chronic migraine were at a significantly increased risk to have mild (RR = 2.5; CI 95% 1.1-6.1), moderate (RR = 3.7; CI 95% 1.5-8.8) and severe (RR = 5.1; CI 95%2.1-11.9) cervical disability relative to those with episodic migraine. Relative risks remained significant after adjustments. Time since episodic or chronic migraine onset significantly influenced the model (P = .035), but age and headache intensity did not (P = .27; P = .46).
  
  
  CONCLUSIONS
  Neck pain significantly adds to the overall disability of individuals with episodic and chronic migraine.
authors.affiliation: Departament of Biomechanics, Medicine and Locomotor Apparatus Rehabilitation, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil.
authors.forename: Lidiane L
authors.initials: LL
authors.lastname: Florencio
authors.forename: Thaís C
authors.initials: TC
authors.lastname: Chaves
authors.forename: Gabriela F
authors.initials: GF
authors.lastname: Carvalho
authors.forename: Maria C
authors.initials: MC
authors.lastname: Gonçalves
authors.forename: Elisangela C B
authors.initials: EC
authors.lastname: Casimiro
authors.forename: Fabíola
authors.initials: F
authors.lastname: Dach
authors.forename: Marcelo E
authors.initials: ME
authors.lastname: Bigal
authors.forename: Débora
authors.initials: D
authors.lastname: Bevilaqua-Grossi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications*; D019547:Neck Pain / Q000150:complications* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Neck Disability Index; cervical pain; chronic migraine; migraine; relative risk