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Analysis of the cranio-cervical curvatures in subjects with migraine with and without neck pain

  • Gabriela Natália Ferracini
    Correspondence
    Corresponding author. Address: Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Avenida dos Bandeirantes, 3900, 14048-900, Ribeirão Preto, São Paulo, Brazil.
    Affiliations
    Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP, Ribeirão Preto, São Paulo, Brazil
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  • Thais Cristina Chaves
    Affiliations
    Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP, Postgraduate Program of Rehabilitation and Functional Performance, Ribeirão Preto, São Paulo, Brazil
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  • Fabíola Dach
    Affiliations
    Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP, Responsible for the Headache and Craniofacial Pain Outpatient Clinic, University Hospital, Faculty of Medicine of Ribeirão Preto, Ribeirão Preto, São Paulo, Brazil
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  • Débora Bevilaqua-Grossi
    Affiliations
    Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP, Postgraduate Program of Rehabilitation and Functional Performance, Ribeirão Preto, São Paulo, Brazil
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  • César Fernández-de-las-Peñas
    Affiliations
    Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Rey Juan Carlos University, Alcorcón, Spain
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  • José Geraldo Speciali
    Affiliations
    Department of Neurosciences and Behavioral Sciences, Faculty of Medicine of Ribeirão Preto, University of São Paulo—FMRP-USP, Ribeirão Preto, São Paulo, Brazil
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      Abstract

      Objective

      To investigate the differences in head and cervical spine alignment between subjects with migraine and healthy people.

      Design

      A cross-sectional, observational study.

      Participants

      Fifty subjects with migraine and 50 matched healthy controls.

      Main outcomes measures

      The presence of neck pain and neck pain-related disability was assessed. Four angles (high cervical angle, low cervical angle, atlas plane angle and cervical lordosis Cobb angle) as well as four distances (anterior translation distance, C0 to C1 distance, C2 to C7 posterior translation and hyoid triangle) were calculated using digitalised radiographs and analysed using K-Pacs® software.

      Results

      Subjects with migraine reported a longer history of neck pain symptoms, and higher pain intensity and neck-pain-related disability than controls (P < 0.01). Patients exhibited a smaller anterior translation distance (mean difference: 4.9 mm, 95% confidence interval 1.8 to 8.8; P < 0.001) and hyoid triangle (difference: 3.0 mm, 95% confidence interval 1.0 to 5.0; P = 0.02) than healthy controls. When the presence or the absence of neck pain was included in the analysis, the differences did not change. Differences in anterior translation and hyoid triangle distances were considered clinically relevant for subjects with migraine suffering from neck pain.

      Conclusion

      Subjects with migraine exhibited straightening of cervical lordosis curvature. The presence of neck pain did not influence head posture in subjects with and without migraine.

      Keywords

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