Generalized Mechanical Pain Sensitivity Over Nerve Tissues in Patients With Strictly Unilateral Migraine

Fernández‐de‐las‐Peñas, César; Arendt-Nielsen, Lars; Cuadrado, María‐Luz; Pareja, Juan A.

doi:10.1097/ajp.0b013e31819655b3

Cited by 32 publications

(38 citation statements)

References 35 publications

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“…This relationship is consistent with the clinical impression of a tendency towards an anatomical spreading of pain with time but has to be confirmed in future prospective studies. Also other studies have shown widespread hyperalgesia in a wide range of chronic pain conditions, including WAD [8,9,18,21], fibromyalgia [19,21,69,70], tension-type headache [16,71], idiopathic neck pain [17], epicondylalgia [14], pelvic pain syndrome [15], and low-back pain [13,72]. Based on studies of chronic WAD [6,9,68,73-76] we recently concluded, that widespread hypersensitivity of pressure can be present without widespread clinical pain [77], which is in agreement with the present results.…”

Section: Discussionmentioning

confidence: 99%

An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

Sjörs

Larsson

Persson³

et al. 2011

BMC Musculoskelet Disord

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BackgroundNeck-shoulder pain conditions, e.g., chronic trapezius myalgia, have been associated with sensory disturbances such as increased sensitivity to experimentally induced pain. This study investigated pain sensitivity in terms of bilateral pressure pain thresholds over the trapezius and tibialis anterior muscles and pain responses after a unilateral hypertonic saline infusion into the right legs tibialis anterior muscle and related those parameters to intensity and area size of the clinical pain and to psychological factors (sleeping problems, depression, anxiety, catastrophizing and fear-avoidance).MethodsNineteen women with chronic non-traumatic neck-shoulder pain but without simultaneous anatomically widespread clinical pain (NSP) and 30 age-matched pain-free female control subjects (CON) participated in the study.ResultsNSP had lower pressure pain thresholds over the trapezius and over the tibialis anterior muscles and experienced hypertonic saline-evoked pain in the tibialis anterior muscle to be significantly more intense and locally more widespread than CON. More intense symptoms of anxiety and depression together with a higher disability level were associated with increased pain responses to experimental pain induction and a larger area size of the clinical neck-shoulder pain at its worst.ConclusionThese results indicate that central mechanisms e.g., central sensitization and altered descending control, are involved in chronic neck-shoulder pain since sensory hypersensitivity was found in areas distant to the site of clinical pain. Psychological status was found to interact with the perception, intensity, duration and distribution of induced pain (hypertonic saline) together with the spreading of clinical pain. The duration and intensity of pain correlated negatively with pressure pain thresholds.

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Section: Discussionmentioning

confidence: 99%

An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

Sjörs

Larsson

Persson³

et al. 2011

BMC Musculoskelet Disord

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“…24 Sensitization mechanisms have been examined by assessing pressure pain thresholds (PPT) over nerve trunks in patients with whiplash-associated disorders, 57,59 mechanical neck pain, 51 chronic tension type headache, 26 or migraine. 25 Generalized sensitization identified by lower PPT over the median, radial, and ulnar nerve trunks has been found in patients with whiplash 57,59 and unilateral migraine, 25 suggesting possible hyperexcitability of the central nervous system. 34 It has also been shown that patients with unilateral LE 23 and unilateral CTS 28 exhibited signs of central hyperexcitability as demonstrated by lower PPT over the median, ulnar, and radial nerve trunks bilaterally when compared to healthy controls.…”

Section: Participants P Atients Diagnosed With Cts Bymentioning

confidence: 99%

Specific Mechanical Pain Hypersensitivity Over Peripheral Nerve Trunks in Women With Either Unilateral Epicondylalgia or Carpal Tunnel Syndrome

Fernández‐de‐las‐Peñas

Ortega‐Santiago²,

Ambite-Quesada³

et al. 2010

J Orthop Sports Phys Ther

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“…The frequency of migraine attacks and the duration of the disorder did not correlate with the number of painful arteries in our migraineurs, while Calandre et al [5] did find such correlation in relation to the number of muscle trigger points, and Fernandez-de-las-Peñas et al [13] found a negative correlation with pressure pain threshold in the supraorbital nerve. Our data suggest that arterial pain is often inherent in migraine, while attack frequency and duration of the disorder are regulated by other factors, most probably hypersensitivity of pain-regulating centers.…”

Section: Discussionmentioning

confidence: 77%

“…Many studies have evaluated pressurepain threshold or tenderness or trigger points in pericranial muscles [1][2][3][4][5][6][7][8] and nerves [13]. Surprisingly, the most frequent ''trigger'' (not only ''tender'') points detected by Calandre et al [5] are located in the same areas (''anterior temporal'' in 42.6% and ''suboccipital'' in 33.4%) of the arteries we found to be most frequently painful.…”

Section: Discussionmentioning

confidence: 81%

Painful scalp arteries in migraine

et al. 2010

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Previous studies suggest a role of scalp perivascular structures in at least a substantial number of migraineurs. This study aimed to evaluate the presence of pressure-painful scalp arteries in patients with migraine. Pressure-painful points on scalp arteries were searched for in 100 consecutive patients affected with migraine, 84 females (F) and 16 males (M), 83 without aura (70 F) and 17 with aura (14 F), and in 30 healthy matched subjects. The examined arteries were, bilaterally, the superficial temporal and its frontal branch, the zygomatico-orbital, the occipital and the posterior auricular. We examined 75 patients interictally: 60 (80.0%) reported one or more (mean per subject 3.7 ± 1.9) pressure-painful arteries and 15 (20.0%) reported none. In the 30 controls, pressure-painful arteries were present in only nine (30.0%, mean per subject 1.3 ± 0.7), with highly significant differences (p < 0.001). During a migraine attack, of the 51 patients examined, 45 (88.2%, 38F) reported one or more (mean 3.8 ± 2.1) pressure-painful arteries and six (11.8%) reported none. Both when during an attack and interictally, the arteries most frequently involved were the occipital, the frontal branch, and the temporal. Scalp arteries are frequently painful to pressure in migraineurs, especially in females, both during headache and interictally. Painful arteries suggest hypersensitivity of periarterial nociceptive afferents, which is perhaps due to the local presence of endogenous algogenic products, as suggested by our previous studies.

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Generalized Mechanical Pain Sensitivity Over Nerve Tissues in Patients With Strictly Unilateral Migraine

Cited by 32 publications

References 35 publications

An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

An increased response to experimental muscle pain is related to psychological status in women with chronic non-traumatic neck-shoulder pain

Specific Mechanical Pain Hypersensitivity Over Peripheral Nerve Trunks in Women With Either Unilateral Epicondylalgia or Carpal Tunnel Syndrome

Painful scalp arteries in migraine

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