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Physiother Can. 2015 Winter;67(1):30-8. doi: 10.3138/ptc.2012-47.

An Exploratory Study to Determine the Relationship between Cervical Dysfunction and Perimenstrual Migraines.

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Physiotherapy Department, University of the Witwatersrand, Johannesburg, South Africa.


in English, French


To determine whether an association between cervical dysfunction and perimenstrual migraines exists.


Forty perimenstrual migraine sufferers and 46 controls were compared. Information on the participants' ages and perceptions of neck pain and stiffness were solicited. The blinded physical examination of the cervical area consisted of postural, range of motion, muscle strength, muscle length, trigger point, neural mobility, and segmental cervical joint movement assessment.


The migraine group had increased perception of neck pain and stiffness (p<0.001); reduced bilateral rotation (p=0.013); decreased muscle length in both trapezii, left sternocleidomastoid, and right occipitals (p=0.045); more pain on muscle stretch in both levator scapulae, both trapezii, left sternocleidomastoid, and both occipitals (p=0.013); increased trigger points bilaterally in the left trapezius (p=0.021), right trapezius (p=0.023), left sternocleidomastoid (p=0.0.004), and right sternocleidomastoid (p=0.021); reduced neural mobility with bilateral elbow lag (p=0.043); greater C4-C6 pain (p=0.045); and increased cervical stiffness in C5-C7 (p=0.023). There were no differences in posture and muscle strength. Decreased muscle length increased the risk of perimenstrual migraines 2.4-6.7 fold, reduced neural mobility 5.8-10.7 fold, and increased C7 stiffness 17.0 fold.


The results suggest that an association between cervical dysfunction and perimenstrual headaches should be further explored.


cervical pain; headache; menstruation; migraine disorders

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