School of Health and Rehabilitation Sciences, Therapies Annexe, 84A, The University of Queensland, St Lucia, QLD, 4072, Australia.
Musculoskelet Sci Pract. 2023 Aug;66:102801. doi: 10.1016/j.msksp.2023.102801. Epub 2023 Jun 14.
Neck pain is one of the most common and burdensome symptoms associated with migraine. Many individuals with migraine and neck pain seek neck treatment, but evidence for such treatment is limited. Most studies have treated this population as a homogenous group, providing uniform cervical interventions that have yet to show clinically important effects. However, different neurophysiological and musculoskeletal mechanisms can underlie neck pain in migraine. Targeting treatment to specific underlying mechanisms may therefore be the key to improving treatment outcomes. Our research characterised neck pain mechanisms and identified subgroups based on cervical musculoskeletal function and cervical hypersensitivity. This suggests that specific management aimed towards addressing mechanisms relevant to each subgroup might be beneficial.
This paper explains our research approach and findings to date. Potential management strategies for the identified subgroups and future research directions are discussed.
Clinicians should perform skilled physical examination with the aim of identifying if patterns of cervical musculoskeletal dysfunction and or hypersensitivity are present in the individual patient. There is currently no research into treatments differentiated for subgroups to address specific underlying mechanisms. It is possible that neck treatments addressing musculoskeletal impairments may be most beneficial for those subgroups where neck pain is primarily due to musculoskeletal dysfunction. Future research should define treatment aims and select specific subgroups for targeted management to determine which treatments are most effective for each subgroup.
Not applicable.
颈部疼痛是偏头痛相关的最常见和最令人痛苦的症状之一。许多偏头痛伴颈部疼痛的患者会寻求颈部治疗，但这种治疗的证据有限。大多数研究将这一人群视为同质群体，提供统一的颈椎干预措施，但尚未显示出具有临床意义的效果。然而，不同的神经生理学和肌肉骨骼机制可能是偏头痛颈部疼痛的基础。因此，针对特定潜在机制的治疗可能是改善治疗效果的关键。我们的研究对颈部疼痛机制进行了特征描述，并根据颈椎肌肉骨骼功能和颈椎高敏性确定了亚组。这表明针对每个亚组相关机制的特定管理可能是有益的。
本文解释了我们迄今为止的研究方法和发现。讨论了为确定的亚组确定潜在的管理策略和未来的研究方向。
临床医生应进行熟练的体格检查，目的是确定个体患者是否存在颈椎肌肉骨骼功能障碍和/或高敏模式。目前还没有针对亚组进行区分以解决特定潜在机制的治疗研究。针对肌肉骨骼损伤的颈部治疗可能对那些主要由于肌肉骨骼功能障碍引起颈部疼痛的亚组最有益。未来的研究应确定治疗目标，并选择特定的亚组进行针对性管理，以确定哪种治疗对每个亚组最有效。
不适用。
