Precipitating and relieving factors of migraine versus tension type headache

Abstract

BackgroundTo determine the differences of precipitating and relieving factors between migraine and tension type headache.MethodsThis is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a predetermined list of precipitating and relieving factors.ResultsIn this study, the female patients predominated (67%). Most of the patients were within 21–30 years age group (58.6%). About 58% of them belonged to middle class families. The common precipitating factors like stress, anxiety, activity, journey, reading, cold and warm were well distributed among both the migraine and tension type headache (TTH) patients. But significant difference was demonstrated for fatigue (p < 0.05), sleep deprivation (p < 0.05), sunlight (p < 0.01) and food (p < 0.05), which were common among migraineurs. In consideration of relieving factors of pain, different maneuvers were commonly tried by migraineurs and significant difference were observed for both analgesic drug and massage (p < 0.05), which relieved migraine headache. But maneuvers like sleep, rest and posture were used by both groups.ConclusionThe most frequent precipitating factors for headache appear to be identical for both migraine and TTH patients. Even though some factors like fatigue, sleep deprivation, sunlight and food significantly precipitate migraine and drug, massage are effective maneuver for relieving pain among migrianeurs.

Reduction in perceived stress as a migraine trigger

“…Trigger factors, measurable precipitants associated with an increased probability of an attack, can include stressful events, hormonal changes, weather changes, and certain foods, although some studies demonstrate reduced odds for migraine attacks in relation to certain variables. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] In patient surveys, perceived stress was associated with migraine onset in up to 80% of respondents. [13][14][15][16] Diary studies have shown that "daily hassles" significantly increase in the 2-to 3-day period before a migraine day.…”

“…[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Premonitory features include changes in mood or behavior that precede the onset of an attack. Trigger factors, measurable precipitants associated with an increased probability of an attack, can include stressful events, hormonal changes, weather changes, and certain foods, although some studies demonstrate reduced odds for migraine attacks in relation to certain variables.…”

“…Because each subject contributed many days of observations, random-effects models were used to take within-subject correlation into account. Specifically, logitnormal models with a random subject-specific intercept were used to estimate a subject-specific odds ratio (OR) for the association of the stress variables from the evening diaries with migraine occurrence within specific time frames (6,12,18, and 24 hours after diary entry). Understanding the time course may clarify mechanisms and contribute to the development of therapies.…”

International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study

“…Patients suffering from headache commonly use self-management strategies such as selfmassage, posture correction, stretching and exercises to reduce symptoms (Haque et al 2012) and seek to reduce medication intake by using additional non-pharmacological therapies, most commonly physiotherapy (Chaibi et al 2011;Russell 2012, 2014;Kristoffersen et al 2012). A physiotherapist will conduct a patient interview to record the headache history, its temporal pattern, symptom behaviour, the patient's medication intake and other relevant health history to ensure that the headache is benign and to classify the type of headache.…”

Prevalence of carpal tunnel syndrome in cases with migraine and tension type headache

“…23 In another study (2012), it was reported that both migraine and TTH are seen more frequently in those with middle level socioeconomic situation. 24 In a study carried out by Carod-Artal et al, it was shown that low-income level is a risk factor for chronic migraine. 25 …”