Migraine Comorbidities: Back Pain

Written by Lorene Alba | January 25, 2023

Along with migraine, do you experience back pain? Many people with migraine also have back, joint, shoulder, and neck pain.

In fact, according to the U.S Pain Foundation’s 2022 survey report, A Chronic Pain Crisis, 95% of adults surveyed said they have at least one other comorbid (chronic) pain condition.

Causes of Migraine and Back Pain

If you have more than one chronic pain condition, it’s likely you have pain in your joints, back, shoulders and neck. Below are a few examples of conditions that can add to the pain of migraine:

  • Autoimmune Arthritis generally includes swelling and/or pain in multiple joints and usually gets worse as you get older. According to the Arthritis Foundation, there are more than 100 different forms of arthritis and related diseases. Swelling from psoriatic arthritis commonly causes lower back pain. Ankylosing spondylitis symptoms also include low back pain, stiffness, and headache. Rheumatoid arthritis tends to cause pain, swelling and stiffness in the fingers, knees and other joints on both sides of the body.
  • Fibromyalgia includes many symptoms that affect the central nervous system. These includes aching and pain especially at certain “trigger points,” tingling in the hands and feet, headache, allodynia, back pain, and extreme fatigue.
  • Infections like meningitis, which is swelling around the spinal cord and brain. Headache, fever, and stiff neck are common symptoms of meningitis.
  • Injuries are caused by lifting something the wrong way, or car or sports accidents. Pain may be in the lower or upper back, shoulders, and neck.
  • Kidney conditions like kidney stones or polycystic kidney disease (noncancerous cysts found on the kidneys) cause lower back pain.
  • Osteoarthritis often develops slowly and can affect multiple different joints. Symptoms can appear and disappear but can also become persistent and cause ongoing pain, swelling and stiffness, and limit movement. When it affects the shoulder and/or neck joints, osteoarthritis can be a contributing factor in triggering migraine attacks.
  • Poor posture and repetitive movements put a strain on your back, shoulder, and neck muscles.
  • Pregnancy can cause pressure on your spinal cord and nerves. Your posture also changes during pregnancy.
  • Premenstrual Syndrome (PMS) can occur a few days before a woman starts her menstrual cycle every month. PMS can cause intense lower back pain and migraine attacks.


Treatments for all of these conditions often overlap. A combination of medications and lifestyle changes is recommended.

  • Take medications as directed: Take all medications as prescribed, along with any supplements your doctor may recommend. Talk with your doctor before starting or stopping any medication, supplement, or therapy.
  • Follow a healthy diet: Avoid food and drink that trigger your pain and migraine attacks. Incorporate foods that provide high nutritional content, and stay hydrated by drinking plenty of water.
  • Pay attention to your posture: If you sit at a desk or stand for hours, notice if you are hunched over. Try to stand or sit up straight. Place your computer monitor at eye level so you don’t have to hold your neck in a strained up-or-down position. Take stretch breaks every hour. Physical therapy may be able to help you with this.
  • Keep moving: Moving your body can reduce current pain and strengthen muscles and bones to avoid future pain. Gentle moving like chair yoga or walking can make a big difference. Strenuous physical activity can also trigger or aggravate pain, so try not to overdo it. This is another area where physical therapy may be able to help, although it is important for you to partner with your PT in order to avoid potential flare ups.
  • Pace yourself: Pacing is key to managing chronic pain and migraine attacks. We often feel the need to do lots of activities today to make up for what we couldn’t accomplish yesterday. However, doing too much at one time may cause worse pain later. Try to pace yourself. Instead of completing all 10 items on your to-do list, prioritize the top three to five items. The remaining items can wait.
  • Talk to a pain management specialist When conservative options fail, such as the above and physical therapy, a pain management doctor will be able to work with you to explore other possible treatments such as neurostimulation, epidurals, and in severe cases even surgery.

Develop a Comprehensive Pain Management Plan

If you think you may have any of the above conditions or are concerned about symptoms, talk with your doctors about a pain management treatment plan. A comprehensive treatment plan that manages all of your conditions will be most successful, especially in determining which treatments may be able to help more than one condition, and which might aggravate another condition.

Let us know!

Are you experiencing back, joint, shoulder, or neck pain? Do you see a pain specialist? How do you manage your multiple chronic pain conditions?

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