A clinical guide for physiotherapists to assess and manage cervical musculoskeletal impairment and pain sensitivity in migraine patients

INTRODUCTION: Migraine is a complex neurological disorder characterized by different signs and symptoms, often presenting with an altered pain sensitivity and cervical musculoskeletal impairments. Thus, the management of migraine patients should include the assessment and eventually a specific treatment of these characteristics.

PURPOSE: Physiotherapists play a key role in identifying and managing cervical musculoskeletal impairments and altered pain sensitivity in migraine patients. This manuscript provides evidence-based guidance on assessment techniques and clinical reasoning strategies to help physiotherapists effectively evaluate and interpret these characteristics in clinical practice.

IMPLICATION: This manuscript serves as a practical guide for physiotherapists by: Outlining physiotherapy assessment techniques for migraine patients.Providing reference cutoff values to identify increased pain sensitivity and cervical dysfunctions.Supporting individualized clinical reasoning to understand these characteristics within each patient's overall condition.Clarifying the rationale behind physiotherapy interventions and integrating hands-on and hands-off therapeutic approaches based on patient-specific needs.