Background & Aims
More than 70% of individuals experiencing migraines, exhibit neck pain before or during attacks. Previous studies have demonstrated that migraine patients display heightened referred pain during sustained pressure in this area compared to healthy controls. However, it remains unclear whether this finding is associated with cervical disability or is merely indicative of heightened sensitivity. Consequently, this study aimed to investigate whether sensitivity in the upper cervical spine, as assessed through the upper cervical palpation test, can be attributed to neck disability, central or local increased pain sensitivity.
Methods
Women and men with migraine (n=52) and headache-free controls (n=45) were recruited. Both groups answered the questionnaires Neck Disability Inventory (NDI), Central Sensitization Inventory (CSI), and the migraine group also completed the Allodynia Symptom Checklist (ASC-12). Both groups were examined regarding pressure pain threshold assessed with an algometer, and mechanical pain threshold measured using pin pricks, and pain sensitivity in the upper cervical spine using a routine physiotherapeutic procedure. Descriptive data analysis was performed for sample characterization for both groups (migraine and control group). A one-factor ANOVA with Bonferroni-corrected post-hoc tests was performed to analyze the difference between groups, considering as factors the palpation response (no pain, local pain and referred to head pain). An additional logistic regression analysis was performed to analyze which variables best explain pain sensitivity in the upper cervical spine.
Results
In the sample, 45 (46.4%) were women and the mean age was 32.3 (SD 13.1) years of which 51 participants (52.6%) reported neck pain. Regarding the palpation test, 22.7% had no pain, 45.4% had local pain and 32% had referred pain. The NDI had 5.3(4.3) points, CSI had 28.6 (12.1) points and ASC-12 had 4.1(3.3) points. The ANOVA showed a difference between the three upper cervical palpation test subgroups (no pain, local pain and referred pain) only for neck disability, which was statistically different between the no pain and referred pain groups. The logistic regression analysis showed that the sensitivity in the upper cervical spine can be explained by neck disability, and an odds ratio of 2.5 indicates that the worst the sensitivity to palpation, the least the chance to have no disability (?=-3.797; SD=1.502; p=0.011) or mild disability (?=-2.942, SD=1.473; p=0.046) in NDI.
Conclusions
The study revealed that most of the sample experienced local pain, followed by referred pain during the upper cervical palpation test. Additionally, participants exhibited mild neck disability, subclinical central sensitization, and mild allodynia. Notably, a distinction in disability emerged when comparing individuals with no pain versus those with referred pain. Importantly, the sensitivity in the upper cervical spine cannot be solely attributed to neck disability; it also signifies a 2.5 times lower chance for individuals with referred pain to be free of neck disability.
References
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Presenting Author
Juliana Pradela
Poster Authors
Juliana Pradela
MSc
University of São Paulo
Lead Author
Melanie Maria Otto
University of Lübeck
Lead Author
Emily Kaske
University of Lübeck
Lead Author
Luise John
University of Lübeck
Lead Author
Nicole Derner
University of Lübeck
Lead Author
Kerstin Luedtke
University of Luebeck
Lead Author
Topics
- Assessment and Diagnosis