Migraines that involve eye symptoms can be incredibly difficult to treat. Standard neurological approaches sometimes fall short, leaving patients discouraged and still in pain. One reason is that the muscular system, particularly the cervical muscles, is often left out of the conversation.
The sternocleidomastoid muscle, which connects the head, neck and upper spine, has direct neurological relationships with both the trigeminal system and upper cervical nerves. When irritated or tight, this muscle can mimic or drive migraine symptoms – headache, eye redness, drooping eyelids, and restricted neck movement.
This case demonstrates how important it is to assess and treat the musculoskeletal system in patients whose migraines don’t respond to conventional care.
Patient Profile
Initial Presentation
On arrival, the patient reported an 8/10 right-sided headache, constant redness in the right eye, and noticeable eyelid drooping. She also had limited neck rotation and significant functional impairment due to pain.
Assessment & Diagnosis
The combination of a one-sided headache, eye involvement and limited cervical movement suggested a musculoskeletal cause, rather than purely a neurological one. The sternocleidomastoid muscle stood out as the likely driver of symptoms, due to its anatomical links and the patient’s pattern of complaints.
Working Diagnosis: Chronic migraine secondary to sternocleidomastoid trigger-point syndrome with cervical dysfunction.
Treatment Approach
The treatment strategy aimed to relieve immediate symptoms and restore balance to the neck muscles. Three primary steps were used:
Outcomes & Results
First Session: Pain dropped by 50% (from 8/10 to 4/10) within minutes; eye redness improved by 80% in the same session; and eyelid drooping improved by 90%.
Follow-up: At the four-day follow-up, 80% of the improvements held. The patient reported being able to function much more easily in her daily life.
Treatment Completion: After three total sessions, the patient’s migraines and eye symptoms had completely resolved and did not return during the follow-up period.
Discussion
This case emphasizes the importance of considering the muscular system in migraine care. The rapid and dramatic response after treating the SCM suggests this muscle was not a secondary factor – it was the main driver of her symptoms.
By treating both the dysfunctional side and the compensating muscles, we were able to provide lasting relief. This approach shows that musculoskeletal interventions should not be an afterthought in chronic headache cases, but considered early in the treatment process.
This patient’s complete recovery after three treatments demonstrates how powerful targeted musculoskeletal work can be. For patients who have tried standard neurological approaches without success, addressing the cervical muscles – especially the sternocleidomastoid – can be life-changing.
Key Takeaways
Clinical Note: This case study is presented for educational purposes. Each patient is unique, and treatments must always be tailored to the individual. Patient consent was obtained for this report.
One of the longest nerves in the body is known as the vagus nerve (VN). The VN is the 10th pair of cranial nerves that originates at the brain stem in the medulla oblongata. This nerve is part of the parasympathetic nervous system, which is a part of the ANS. Research suggests ear acupuncture can activate the VN.
Migraines are unilateral, throbbing headaches, often with concurrent nausea, photophobia, and phonophobia. Approximately 10% of the global population suffers from migraines, with women more than three times as likely as men to experience them. Medication remains a mainstay treatment option, making nondrug alternatives critical to safer practices. New research suggests auricular acupuncture may be one such alternative.
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