Cluster headache pain vs. other vascular headache pain: differences revealed with two approaches to the McGill Pain Questionnaire

Abstract

We compared cluster headache pain and other vascular (migraine and mixed) headache pain on pain intensity ratings and the McGill Pain Questionnaire (MPQ). Cluster headache sufferers reported not only more intense pain and more affective distress, but also different pain qualities than did migraine and mixed headache sufferers. The pain qualities that best distinguished cluster headaches from other vascular headaches were the presence of punctate pressure and thermal sensations and the absence of dull pain. Although cluster headache sufferers and other vascular headache sufferers endorsed different sensory pain qualities, MPQ subscales proved no better than pain intensity ratings at distinguishing these two groups. This finding may have occurred because MPQ subscale scores include an intensity component and do not provide information about specific pain qualities such as that provided by MPQ sensory items. These findings provide evidence that cluster headaches are characterized by distinct pain qualities and are not simply a more intense version of the same vascular headache pain experienced by migraine and mixed headache sufferers. They further suggest than when the MPQ is used to assess specific pain qualities, sensory items and not the sensory subscale are the preferred units for analysis.

Confirmation of the Distinction Between Chronic Migraine and Chronic Tension‐type Headache by the McGill Pain Questionnaire

“…In previous research, a low usage of most of the affective word subclasses of the MPQ, demonstrating a relatively lower affective component, was found in pain after tooth extraction and in tooth pain 15 , 19 , 28 . On the contrary, the affective dimension of pain was found to be high in patients with cluster headache compared to patients with migraine or mixed headache, 21 in chronic pain compared to acute pain, 29 and in myogenous facial pain and in facial pain as a somatoform disorder compared to pain of the TMJ 24,25 . Our present data seem to confirm that high levels of the affective dimension prevail in some types of pain, independently of the level of pain.…”

“…It has been found that the MPQ satisfactorily discriminates between reversible and irreversible tooth nerve damage, 19 trigeminal neuralgia and atypical facial pain, 20 cluster headache and migraine, 21 and between various types of facial pain 22,23 . More recently, the MPQ consistently discriminated between craniomandibular joint pain and facial pain as a somatoform disorder, 24 and between temporomandibular joint (TMJ) pain and myogenic facial pain 25 …”

A comparison of pain perceptions in women with fibromyalgia and rheumatoid arthritis. Relationship to depression and pain extent

“…Descriptite data on this sample are also shown in Table 1. Disease severity was assessed by a question asking patients to rate their current disease activity on a 4-point scale from 1 (not active) to 4 (very active).…”

Pain in public and private places

“…Specific verbal descriptors of the MPQ have also been shown to discriminate between reversible and irreversible damage of the nerve fibers in a tooth,S and between leg pain caused by diabetic neuropathy and leg pain arising from other cause. 13 Jerome et al 9 further showed that the MPQ discriminates between cluster headache pain and other vascular (migraine and mixed) headache pain. It is clear that there are appreciable and quantifiable differences in the way various types of pain are described, and that .patients with the same disease or pain syndrome tend to use remarkably similar words to communicate what they feel.…”