Taking people in TürkiyeNo phase

Pain Mechanisms in Migraine, Neck Pain, and Lower Back Pain

Compares pain processing in adults with migraine, migraine-related neck pain, or low back pain.

Key facts

Who runs it: Bozok University
Where: Gaziantep, TürkiyeSee the site
Trial code: NCT07567300
Registry title: Common Pain Mechanisms in Migraine, Migraine-Related Neck Pain, and Lower Back Pain: A Cross Sectional Study
Status: Recruiting
People taking part: 179 people, planned
Started: 30 Apr 2026
Expected to end: 30 Nov 2026
Type of study: Observational, 8 groups
Record updated: 1 October 2026

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults with migraine who also have neck pain and/or lower back pain with no other known cause. It also includes a control group without migraine.

Age: 18 to 65 years
Sex: All sexes can join
Disease stage: Episodic or chronic migraine, diagnosed by International Classification of Headache Disorders Edition 3 criteria, together with neck pain and/or lower back pain with no underlying diagnosis.

Main reasons for not taking part

Neurological disorder in the past, such as Multiple Sclerosis
Inflammatory rheumatic disease or generalized chronic pain syndrome, such as Fibromyalgia
Any other headache disease or any other systemic disease
Spinal surgery, spinal disease diagnosis or serious musculoskeletal trauma within the last 6 months
Pregnancy

The registry criteria, word for word

Show all 15 criteriaShow less

Who can take part

Being between 18 and 65 years of age,
Being able to read and understand Turkish,
Agreeing to participate voluntarily,
Having an episodic or chronic migraine diagnosis according to the International Classification of Headache Disorders Edition 3 criteria
Having neck pain and/or lower back pain without any underlying diagnosis accompanying the migraine diagnosis

Who cannot take part

A history of neurological disorder (e.g., Multiple Sclerosis),
Inflammatory rheumatic disorders (e.g., Rheumatoid Arthritis), generalized chronic pain syndromes (e.g., Fibromyalgia),
Any other headache disease, any other systemic disease,
Acute fracture and infection,
Spinal surgery or spinal disease diagnosis within the last 6 months,
A cognitive or psychiatric condition that would prevent completion of the questionnaires,
A history of recurrent headaches within the last year
Serious musculoskeletal trauma within the last 6 months,
Pregnancy,
In the control group without a migraine diagnosis,

Check if you might fit

Answer for yourself. This is not a decision: only the study team can say whether you can take part.

Are you between 18 and 65 years old?

Where in Türkiye

Gazi UniversityGaziantep, TürkiyeContact: Pelin Yenilmez Yeşildaş, NeurologistTaking people

About the trial

What the trial wants to find out

Migraine is one of the primary headache disorders with a high prevalence worldwide, leading to significant disability and reduced quality of life. Trigeminal nerve activation and alterations in central pain processing mechanisms play a crucial role in the pathophysiology of migraine. Recent studies suggest that migraine may not only be a headache disorder but also a systemic pain disorder associated with changes in central pain processing mechanisms. Central sensitization is defined as increased sensitivity of nociceptive neurons in the central nervous system to afferent stimuli and is considered a key mechanism in the development and maintenance of chronic pain conditions. This condition is characterized by pain hypersensitivity, allodynia, and generalized pain sensitivity.

Read full original descriptionShow less

In addition to headaches, other musculoskeletal pains are also frequently reported in migraine patients. Spinal pain, particularly neck and lower back pain, can occur in migraine sufferers, with central sensitization contributing to the condition, considering the spine as a chain. Large population-based studies have shown a significant association between primary headaches and persistent low back pain, and a higher prevalence of concomitant low back pain has been reported in individuals with chronic migraine and chronic tension-type headaches. This association is suggested to be explained by the shared nociceptive pathways of the head and spinal structures and the changes in central pain processing seen in chronic pain conditions.

This relationship between migraine and musculoskeletal pain is also explained by the presence of shared neuroanatomical structures such as the trigemino-cervical complex. Nociceptive afferents from the upper cervical spine and cranial structures converge at the trigemino-cervical complex level in the brainstem, creating a predisposition to the co-occurrence of head and neck pain. This mechanism suggests that pain or dysfunction in the cervical region in migraine patients may be related to headache symptoms. Studies have shown that neck pain is more common in individuals with migraine than in the general population, and research suggests this rate may be approximately 10-12 times higher compared to healthy individuals. Furthermore, it has been reported that individuals with migraine more frequently experience tenderness in cranio-cervical muscles such as the upper trapezius, sternocleidomastoid, and suboccipital muscles, myofascial trigger points, and increased muscle sensitivity. The literature also emphasizes that these cervical symptoms may be related to migraine frequency, attack severity, and headache-related disability.

These findings suggest that migraine should be considered not only as a primary headache disorder but also as a complex neurobiological condition associated with widespread pain sensitivity and musculoskeletal symptoms. A better understanding of the relationship between migraine and musculoskeletal pain could be important for developing multidisciplinary treatment approaches. However, clinical studies in the literature that evaluate migraine, accompanying neck pain, and lower back pain together in terms of common pain mechanisms are quite limited. Therefore, the rationale for this study is that examining factors such as central sensitization, pain threshold, pain catastrophizing, psychological factors, body awareness, and regional disability together in migraine patients can lead to a better understanding of the pathophysiology of migraine-related musculoskeletal pain. Based on all these reasons and evidence, the aim of this study is to investigate the possible common pain mechanisms and musculoskeletal pathophysiological processes of migraine-related neck and back pain in migraine patients with accompanying neck and/or back pain by evaluating factors such as central sensitization, pain threshold, pain catastrophizing, psychological factors, body awareness, and regional disability together.

The 8 groups in the trial

Episodic migraine
Episodic migraine is a neurological condition characterized by recurrent, moderate-to-severe headaches occurring on fewer than 15 days per month. Attacks typically last 4 to 72 hours and are often accompanied by nausea, vomiting, and light/sound sensitivity. Treatment involves acute, on-demand medication and preventative strategies to reduce attack frequency.
Episodic migraine with neck pain
Episodic migraine is a neurological condition characterized by recurrent, moderate-to-severe headaches occurring on fewer than 15 days per month. Attacks typically last 4 to 72 hours and are often accompanied by nausea, vomiting, and light/sound sensitivity. Treatment involves acute, on-demand medication and preventative strategies to reduce attack frequency. Additionally, this sample includes individuals diagnosed with episodic migraine and experiencing neck pain without having any other diagnosed neck problems.
Episodic migraine with low back pain
Episodic migraine is a neurological condition characterized by recurrent, moderate-to-severe headaches occurring on fewer than 15 days per month. Attacks typically last 4 to 72 hours and are often accompanied by nausea, vomiting, and light/sound sensitivity. Treatment involves acute, on-demand medication and preventative strategies to reduce attack frequency. Additionally, this sample includes individuals diagnosed with episodic migraine and experiencing low back pain without having any other diagnosed lower back problems.
Episodic migraine with neck pain and low back pain
Episodic migraine is a neurological condition characterized by recurrent, moderate-to-severe headaches occurring on fewer than 15 days per month. Attacks typically last 4 to 72 hours and are often accompanied by nausea, vomiting, and light/sound sensitivity. Treatment involves acute, on-demand medication and preventative strategies to reduce attack frequency. Additionally, this sample includes individuals diagnosed with episodic migraine and experiencing neck pain and low back pain without having any other diagnosed neck and lower back problems.
Chronic migraine
Chronic migraine is defined by having 15 or more headache days per month for over three months, with at least eight of those days meeting migraine criteria. Symptoms include moderate-to-severe throbbing pain, nausea, vomiting, and extreme sensitivity to light, sound, or smell.
Chronic migraine with neck pain
Chronic migraine is defined by having 15 or more headache days per month for over three months, with at least eight of those days meeting migraine criteria. Symptoms include moderate-to-severe throbbing pain, nausea, vomiting, and extreme sensitivity to light, sound, or smell. Additionally, this sample includes individuals diagnosed with chronic migraine and experiencing neck pain without having any other diagnosed neck problems.
Chronic migraine with low back pain
Chronic migraine is defined by having 15 or more headache days per month for over three months, with at least eight of those days meeting migraine criteria. Symptoms include moderate-to-severe throbbing pain, nausea, vomiting, and extreme sensitivity to light, sound, or smell. Additionally, this sample includes individuals diagnosed with chronic migraine and experiencing low back pain without having any other diagnosed lower back problems.
Chronic migraine with neck pain and low back pain
Chronic migraine is defined by having 15 or more headache days per month for over three months, with at least eight of those days meeting migraine criteria. Symptoms include moderate-to-severe throbbing pain, nausea, vomiting, and extreme sensitivity to light, sound, or smell. Additionally, this sample includes individuals diagnosed with chronic migraine and experiencing neck pain and low back pain without having any other diagnosed neck and lower back problems.