• Astrid Blaschek, Siona Decke, Lucia Albers, Andreas Sebastian Schroeder, Steffi Lehmann, Andreas Straube, Mirjam N Landgraf, Florian Heinen, and Rüdiger von Kries.
• Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, LMU Munich, Germany astrid.blaschek@med.uni-muenchen.de.
• Cephalalgia. 2014 Oct 1; 34 (11): 895-903.

AimThe aim of the present analysis is to confirm or refute the association of neck pain to migraine or tension-type headache and to assess whether this association is independent of other risk factors for headache.MethodsSecondary school students were invited to complete a questionnaire on headache and lifestyle factors in a cross-sectional study. Neck pain was assessed via (a) a screening question concerning neck pain and (b) denoting affected areas in schematic drawings of the human body.ResultsAbsolute increment in prevalence of headache with pain in the shoulder-neck region was between 7.5% and 9.6%. Gender, grade, stress and lifestyle factors were assessed as potential confounding factors. Nearly all factors were associated with shoulder-neck pain and most with headache. After adjustment for confounders, the association of neck pain with headache was almost completely confined to migraine (OR 2.39; 95% CI 1.48-3.85) and migraine + tension-type headache (OR 2.12; 95% CI 1.50-2.99), whereas the association with isolated tension-type headache was negligible (OR 1.22, 95% CI 0.87-1.69).ConclusionNeck pain is associated with migraine but not with tension-type headache. A possible link between migraine and neck pain may be the cervico-trigeminal convergence of neck and meningeal sensory afferents or a disturbed descending inhibition in migraine.© International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

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