Positive Test Triples Migraine Risk in Women

This Positive Test Triples Migraine Risk in Women: The Flexion-rotation Test.

Migraine is a primary headache disorder and is considered the second most important cause of disability in the world.

It can be challenging to treat as there are many options available, including

• medication
• dietary changes
• ear piercing
• chiropractic
• physical therapy
• acupuncture and
• vestibular rehabilitation.

The presence of neck pain is an important factor related to moderate-to-severe migraine phenotypes. Research has explored this concept and shows a close relationship of the musculoskeletal (cervical spine) impact between neck pain and migraine. Not all of migraine sufferers have some type of cervical (neck) impairment and it can be important to identify the characteristics of neck dysfunction in these individuals.

We find women are more likely to exhibit cervical impairment if they suffer from migraines. Reduced range of motion, strength deficits, and endurance deficits in the cervical musculature can cause these impairments.

We also find women are more likely to exhibit cervical joint hypomobility. Cervical joint hypomobility basically means there is stiffness or lack of motion in one or more levels of the spine. It normally correlates with the reduced strength and endurance of the deep muscles in the neck.

The Flexion-Rotation Test

Healthcare professionals commonly use the flexion-rotation test to assess cervical spine hypomobility. More specifically, they utilize it to identify rotational impairment in the C1/C2 segment.

This test was recently found to have a 3 fold greater association with the risk of a positive test than headache-free individuals by Oliveria-Souza et al in 2019. Here is a video of me performing this test several years ago:

Women with migraines show a higher prevalence of positive findings from the Flexion-Rotation Test (as demonstrated in the video above), and the frequency of migraine attacks appears to be linked to reduced and/or more painful C1-C2 mobility.

If you are suffering from migraines and are looking to have this test performed to determine if you have a cervical spine impairment, contact us for an evaluation.