Generalized neck-shoulder hyperalgesia in chronic tension-type headache and unilateral migraine assessed by pressure pain sensitivity topographical maps of the trapezius muscle
Corresponding Author
C Fernández-de-las-Peñas
Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos,
Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Aesthesiology Laboratory of Universidad Rey Juan Carlos,
César Fernández de las Peñas, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain. Tel. + 34-91-488-8884, fax + 34-91-488-8957, e-mail [email protected]Search for more papers by this authorP Madeleine
Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Search for more papers by this authorAB Caminero
Neurology Department of Hospital Avila, Avila, Spain, and
Search for more papers by this authorML Cuadrado
Aesthesiology Laboratory of Universidad Rey Juan Carlos,
Departments of Neurology of Fundación Hospital Alcorcón and Universidad Rey Juan Carlos, Alcorcón,
Neurology Department, Hospital Clínico San Carlos and Universidad Complutense, Madrid and
Search for more papers by this authorL Arendt-Nielsen
Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Search for more papers by this authorJA Pareja
Aesthesiology Laboratory of Universidad Rey Juan Carlos,
Departments of Neurology of Fundación Hospital Alcorcón and Universidad Rey Juan Carlos, Alcorcón,
Search for more papers by this authorCorresponding Author
C Fernández-de-las-Peñas
Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation of Universidad Rey Juan Carlos,
Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Aesthesiology Laboratory of Universidad Rey Juan Carlos,
César Fernández de las Peñas, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain. Tel. + 34-91-488-8884, fax + 34-91-488-8957, e-mail [email protected]Search for more papers by this authorP Madeleine
Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Search for more papers by this authorAB Caminero
Neurology Department of Hospital Avila, Avila, Spain, and
Search for more papers by this authorML Cuadrado
Aesthesiology Laboratory of Universidad Rey Juan Carlos,
Departments of Neurology of Fundación Hospital Alcorcón and Universidad Rey Juan Carlos, Alcorcón,
Neurology Department, Hospital Clínico San Carlos and Universidad Complutense, Madrid and
Search for more papers by this authorL Arendt-Nielsen
Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Search for more papers by this authorJA Pareja
Aesthesiology Laboratory of Universidad Rey Juan Carlos,
Departments of Neurology of Fundación Hospital Alcorcón and Universidad Rey Juan Carlos, Alcorcón,
Search for more papers by this authorAbstract
Spatial changes in pressure pain hypersensitivity are present throughout the cephalic region (temporalis muscle) in both chronic tension-type headache (CTTH) and unilateral migraine. The aim of this study was to assess pressure pain sensitivity topographical maps on the trapezius muscle in 20 patients with CTTH and 20 with unilateral migraine in comparison with 20 healthy controls in a blind design. For this purpose, a pressure algometer was used to assess pressure pain thresholds (PPT) over 11 points of the trapezius muscle: four points in the upper part of the muscle, two over the levator scapulae muscle, two in the middle part, and the remaining three points in the lower part of the muscle. Pressure pain sensitivity maps of both sides (dominant/non-dominant; symptomatic/non-symptomatic) were depicted for patients and controls. CTTH patients showed generalized lower PPT levels compared with both migraine patients (P = 0.03) and controls (P < 0.001). The migraine group had also lower PPT than healthy controls (P < 0.001). The most sensitive location for the assessment of PPT was the neck portion of the upper trapezius muscle in both patient groups and healthy controls (P < 0.001). PPT was negatively related to some clinical pain features in both CTTH and unilateral migraine patients (all P < 0.05). Side-to-side differences were found in strictly unilateral migraine, but not in those subjects with bilateral pain, i.e. CTTH. These data support the influence of muscle hyperalgesia in both CTTH and unilateral migraine patients and point towards a general pressure pain hyperalgesia of neck-shoulder muscles in headache patients, particularly in CTTH.
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