Background & Aims

Convergence of head and neck afferents in the trigeminocervical complex cre-ates bidirectional vulnerability in migraine (M). Interventions at the cervi-comuscular level are often required, but there is currently insufficient assess-ment of this dysfunction in migraine [1].
Target: assessment of the clinical information content of cervical and sagital imbalance (CSI) based on a comparative analysis of neuromuscular ultrasound data and physical examination.

Methods

The study included patients aged 18–50 years with migraine. Migraine was di-agnosed based on IHS criteria (International Classification of Headache Disor-ders, 3rd Revision , 2018). Participants underwent clinical examination for cervical musculoskeletal dysfunction and neuromuscular ultrasound. Cervical musculoskeletal dysfunction was determined by active complaints of neck pain, with craniovertebral angle (CVA) measured by digital photographic im-aging. CVA was defined as the angle between the line from the spinous process of the seventh cervical vertebra to the tragus of the ear and the horizontal line [2,3].
Muscle size measurements were taken using a Clarius L15 HD3 universal line-ar portable ultrasound scanner . The cross-sectional area of the anterior scalene and sternocleidomastoid muscles, as well as the thickness of the trapezius, splenius, and semispinalis muscles were measured bilaterally in a sitting posi-tion.

Results

Among the 45 patients with migraine, there were 38 women/7 men. The preva-lence of neck pain was significantly higher in individuals with M+SSD (62.7%) than in those with “pure” M (56.2%) (p < 0.05 for these comparison groups). Pain arising during manual examination of the upper cervical spine was pre-sent in 63% of migraine patients. The smaller the CVA angle, the greater the flexion of the lower cervical spine. The mean CVA of the participants was 47.28±6.16°. In patients with and without migraine pain, the mean CVA val-ues were 42.95±3.72° and 51.58±3.4°, respectively. Ultrasonographic comparison of the neck muscles showed the following. The sternocleidomastoid muscle SCM cm 2 - 3.29 (0.67), Scalenus anterior, cm 2 1.25 (0.31), Splenius capitis, cm -0.60 (0.14) Semispinalis capitis, cm -0.56 (0.10) Trapezius, cm 1.20 (0.26). A statistically significant correlation was found between the results of all tests for both sides (3.91; p < 0.01). CVA showed a statistically significant

Conclusions

CVA showed a statistically significant correlation with trapezius muscle thick-ness. Identifying treatments for cervical musculoskeletal disorders may help clinicians improve the management of patients with migraine.

References

Liang Z, Thomas L, Jull G, Treleaven J. Cervical musculoskeletal impairments in migraine. Arch Physiother. 2021 Dec 8;11(1):27. doi: 10.1186/s40945-021-00123-0. PMID: 34876218; PMCID: PMC8653561.
Oliveira-Souza AIS, Carvalho GF, Florêncio LL, Fernández-de-Las-Peñas C, Dach F, Bevilaqua-Grossi D. Intrarater and Interrater Reliability of the Flexion Rotation Test and Cervical Range of Motion in People With Migraine. J Ma-nipulative Physiol Ther. 2020 Nov-Dec;43(9):874-881. doi: 10.1016/j.jmpt.2019.11.005. Epub 2020 Aug 27. PMID: 32861519.
Rist PM, Hernandez A, Bernstein C, Kowalski M, Osypiuk K, Vining R, Long CR, Goertz C, Song R, Wayne PM. The Impact of Spinal Manipulation on Migraine Pain and Disability: A Systematic Review and Meta-Analysis. Headache. 2019 Apr;59(4):532-542. doi: 10.1111/head.13501. Epub 2019 Mar 14. PMID: 30973196; PMCID: PMC6461372.

Presenting Author

Larissa Kuanova

Poster Authors

Lara Kuan

Prof. Dr. med.

Umc

Lead Author

Topics

  • Specific Pain Conditions/Pain in Specific Populations: Muscle and Myofascial pain