Study Results Link Neck, Shoulder Pain With Worse Headache, Migraine Symptoms

Investigators aimed to determine how individuals with and without concomitant NSP differ in characteristics and in their perception of treatment responses to analgesics.

Neck and shoulder pain (NSP) has been associated with worse headache and migraine symptoms, but the efficacy of 100-mg caffeine (IbuCaff) and 400-mg ibuprofen treatment is not substantially different in those who with NSP, according to the results of a study published in Frontiers in Neurology.

Investigators aimed to determine how individuals with and without concomitant NSP differ in characteristics and in their perception of treatment responses to analgesics.

There were 735 individuals with headaches and 160 with migraines in the study who used an analgesic fixed-dose combination containing IbuCaff as a non-prescription treatment. There were 538 individuals who suffered from headaches with NSP and 304 who had headaches without NSP.

Investigators found that NSP occurred in approximately 60% of individuals in the survey and found that NSP was associated with more than 1 additional day of headache per month. Those individuals also reported sedentary work more frequently than those without at 40% and 29%, respectively.

Additionally, they also reported physical tension and poor posture as perceived trigger factors more frequently than those individuals without NSP at 70% and 16%, respectively.

All other triggers, including nutrition, stress, and weather sensitivity, were reported more frequently for individuals with headaches without NSP.

Reported pain reduction was comparable in both the NSP and without NSP groups, regardless of whether assessed as mean pain rating, on a scale of about 6 to 1.5 based on 10 points, patients experiencing a greater than 50% pain reduction at 89.6% and 88.8%, respectively, or becoming pain-free within 2 hours, at 57% and 64%, respectively.

The onset of pain relief after the first dose of IbuCaff was similar in both groups and was reported to be within 6 to 15 minutes or 16 to 30 minutes.

Recurrence of pain and use of another dose within the same day occurred more frequently in the group with NSP than the group without at 53% and 36%, respectively, investigators said.

Furthermore, investigators found that individuals with headaches and NSP were more likely to recommend IbuCaff to others than those without NSP at 91% and 84%, respectively. Also, those individuals with NSP would be more willing to buy it again at 93% compared with those without NSP at 84%.

The study was conducted in 126 community pharmacies in Germany between February and June 2019. Individuals were included if they purchased a branded IbuCaff product and consented.

The individuals filled out the survey at their own discretion after taking IbuCaff to treat pain episodes. The questionnaire was sent to Winicker Norimed GmbH, which collected and analyzed the data. The survey was anonymous, with no data being collected that would allow investigators to identify the individuals. There were no exclusion criteria for the study.

Investigators noted that even though non-interventional and observational studies are useful, they cannot prove efficacy because of the lack of a control group.

However, the efficacy of ibuprofen for the treatment of headaches is undisputed, according to investigators.


Gaul C, Gräter H, Weiser T, Michel MC, et al. Impact of the neck and/or shoulder pain on self-reported headache treatment responses - results from a pharmacy-based patient survey. Front Neurol. 2022;13:902020. doi:10.3389/fneur.2022.902020

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