Visceral Pain Threshold is Deeply Lowered Far From the Head in Migraine

Abstract

A short-lasting over-distension of the hand-forearm veins, obtained through a non-invasive original maneuver (Hand Arm Vein Distension test) induces local pain when applied to migraine sufferers in inter-critical period. Conversely, subjects with an absolutely negative personal and family history for any type of idiopathic headache do not report any pain or only an uncertain, slight one. The injection of 1 mL of 2% to 8% (i.e. 0.34 mol/L to 1.36 mol/L) hypertonic saline into the antecubital vein during an extemporary short (1 minute) circulatory blockage (ischemia induced to guarantee a strictly local action of the chemical stimulus) provokes moderate, strong or unbearable local (arm vein) pain in migraine sufferers but not in subjects with a personal and family history absolutely free from any type of headache. These results show for the first time that migraineurs show a proneness to visceral pain in viscera (veins) distant from the head (arm-hand). Such a finding is consistent with the theory that migraine pain is due to a central derangement of the viscerosensory system.

Are Migraine and Coronary Heart Disease Associated? An Epidemiologic Review

“…The finding that migraineurs were significantly more likely than nonmigraineurs to report chest pain, as well as other categories of pain, is consistent with the theory that migraineurs have a lower pain threshold than nonmigraineurs 7 . Migraineurs have been shown to experience pain to nonpainful stimuli, both during migraine attacks and during intervals between migraine attacks 11,12 . A similar heightened sensitivity to pain has been observed in patients with noncardiac chest pain, which is similar to anginal pain but typically originates from the esophagus 13 …”

Quantitative somatosensory testing of subjects with chronic post‐traumatic headache: Implications on its mechanisms

“…According to the literature, subjects with tension-type headache exhibit lower cranial PPT (Jensen et al, 1993;Andary et al, 1997;Buchgreitz et al, 2006;Fernández-de-las-Peñas et al, 2007), lower extra-cranial PPT (Nicolodi et al, 1994;Bendtsen, 2000) and normal cranial heat-pain threshold (Ashina et al, 2000;de Tommaso et al, 2003). Therefore, comparisons can be made only with studies conducted on subjects with primary headache or headache following whiplash injury.…”

Planet pain: focus on chronic migraine

“…The feature is specific to migraine (alias viscerogenic headache) and is not found in healthy subjects or in patients with tension-type headache. The feature is equally present in all patients without regard to age or gender [17].…”

“…We observed that the worsening of migraine syndrome is paralleled by an increase in the severity of visceral hyperalgesia [12,13,24] according to different methods. Briefly, in one method, sharp stretching of vein walls is induced by a noninvasive maneuver, while another method refers to the application of an osmotic stimulus to the wall of the vessels [17]. Both methods are based on the application of stimuli which are suited, in nature, to activate polymodal receptors of hollow viscera.…”