Features of the pain syndrome in patients with migraine without aura and chronic migraine

March 4, 2019
Specialities :

Aim — to study the peculiarities of pain syndrome in patients with migraine without aura and chronic migraine. The object and methods of research. A total of 31 patients (11 men and 20 women, average age Me (Q1–Q3) 49 (40–52) years) with migraine without aura (1st group, n=20) and chronic migraine (2nd group, n=11) were examined. Clinical neurological examination, palpation of the pericranial and cervical muscles on both sides were carried out, counting the number of tenderness of the pericranial muscles (NTPM) and the number of tenderness of the neck muscles (NTNM) for each patient and their average score in the group; subjective severity of pain was determined with visual analogue scale (VAS) and the qualitative characteristics of headache were identified. Results. Data by the VAS in both groups did not differ significantly, the values were moderate. In both groups, in the study of pericranial and cervical muscles on both sides, pain during palpation ranged from weak to moderate, except for the temporal and belt muscles of the neck on the right side, the belt muscle of head and trapezoid muscle on the left side in patients of group II, where the pain was moderate to severe. The scores of NTPM and NTNM in 1st group on the left and right sides were within the limits of mild to moderate pain, while in 2nd group, they ranged from moderate to severe. In patients of the 1st group, the indicators describing the sensory and psycho-emotional characteristics of headache were statistically significantly higher than similar data from 2nd group. Patients of 1st group found to have direct correlation between the intensity of pain by VAS and affective characteristics of headache, data of the evaluational scale, while patients of 2nd group show direct correlation between the affective characteristics of headache, data of the evaluative scale and number of tenderness of the pericranial and cervical muscles. Conclusions. The presence of muscle pain, sensory and psycho-emotional characteristics of headache must be considered when planning treatment and rehabilitation strategies, which will prevent the progression and chronicity of headache and help to improve the quality of life of the patients.

Published: 04.03.2019


  • Danilov A.B. (2012) Diagnostika i lecheniye fibromialgii. Lech. vrach, 5: 30–34.
  • Breivik H., Borchgrevink P.C., Allen S.M. et al. (2008) Assessment of pain. Br. J. Anaesth., 101(1): 17—24.
  • GBD 2016 Disease and Injury Incidence and Prevalence Collaborators (2017) Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet, 390(10100): 1211–1259.
  • Hagen K., Linde M., Steiner T.J. et al. (2012) The bidirectional relationship between headache and chronic musculoskeletal complaints: an 11-year follow-up in the Nord-Trøndelag Health Study (HUNT). Eur. J. Neurol., 19(11): 1447–1454.
  • Hung Ch.I., Liu Ch.Y., Yang Ch.H., Wang Sh.J. (2016) Headache: an important factor associated with muscle soreness/pain at the two-year follow-up point among patients with major depressive disorder. J. Headache Pain, 17: 57.
  • Janani A.S., Pope K.J., Fenton N. (2018) Resting cranial and upper cervical muscle activity is increased in patients with migraine. Clin. Neurophysiol., 129(9): 1913–1919.
  • May A., Schulte L.H. (2016) Chronic migraine: risk factors, mechanisms and treatment. Nat. Rev. Neurol., 12(8): 455–464.
  • Melzack R. (1975) The McGill Pain Questionnaire: major properties and scoring methods. Pain, 1(3): 277–299.
  • Mongini F., Deregibus A., Rota E. (2005) Psychiatric disorders and muscle tenderness in episodic and chronic migraine. Expert. Rev. Neurother., 5(5): 635–642.
  • Saylor D., Steiner T.J. (2018) The Global Burden of Headache. Semin. Neurol., 38(2): 182–190.
  • Simons D.G., Travell J.G. (1983) Myofascial Pain and Dysfunction: The Trigger Point Manual. Williams & Wilkins, Baltimore/London, 713 p.
  • WHO (2016) Headache disorders (http://www.who.int/mediacentre/factsheets/fs277/en/).