title: Musculoskeletal disorders of the upper cervical spine in women with episodic or chronic migraine.
abstract: BACKGROUND
  The role of musculoskeletal disorders of the cervical spine in migraine is under debate.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  Tertiary university-based hospital.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Identification treatment of the musculoskeletal impairments of the cervical spine may help to clinician for better management of patients with migraine.
authors.affiliation: Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, FMRP-USP, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Gabriela N
authors.initials: GN
authors.lastname: Ferracini
authors.affiliation: 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.
authors.forename: Lidiane L
authors.initials: LL
authors.lastname: Florencio
authors.affiliation: Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, FMRP-USP, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Fabíola
authors.initials: F
authors.lastname: Dach
authors.affiliation: 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.
authors.forename: Débora
authors.initials: D
authors.lastname: Bevilaqua Grossi
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Alcorcón, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Palacios-Ceña
authors.affiliation: Department of Neurology, Hospital Rey Juan Carlos, Móstoles, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Ordás-Bandera
authors.affiliation: Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, FMRP-USP, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Thais C
authors.initials: TC
authors.lastname: Chaves
authors.affiliation: Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, FMRP-USP, Ribeirão Preto, São Paulo, Brazil.
authors.forename: José G
authors.initials: JG
authors.lastname: Speciali
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Alcorcón, Spain - cesarfdlp@yahoo.es.
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-Las-Peñas
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002574:Cervical Vertebrae; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000503:physiopathology; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D011187:Posture; D016059:Range of Motion, Articular; D012737:Sex Factors