Pain Extent Is Associated with the Emotional and Physical Burdens of Chronic Tension-Type Headache, but Not with Depression or Anxiety.
- Palacios-Ceña M Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.
- Barbero M Department of Business Economics, Health and Social Care, Rehabilitation Research Laboratory 2rLab, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
- Falla D Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.
- Ghirlanda F Department of Business Economics, Health and Social Care, Rehabilitation Research Laboratory 2rLab, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
- Arend-Nielsen L Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), School of Medicine, Aalborg University, Aalborg, Denmark.
- Fernández-de-Las-Peñas C Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.
- 2017-04-08
Published in:
- Pain medicine (Malden, Mass.). - 2017
Anxiety
Burden
Depression
Pain Area
Pressure Pain
Tension Type Headache
Adult
Anxiety
Central Nervous System Sensitization
Chronic Pain
Depression
Female
Humans
Male
Middle Aged
Pain Measurement
Pain Threshold
Tension-Type Headache
English
Objective
Earlier studies suggest that pain extent, extracted from the patients' pain drawings, can help clinicians to identify people with central sensitization or worse clinical features. Our aim was to investigate possible associations between perceived pain extent and clinical pain features, burden of headache, psychological outcomes, and pressure sensitivity in people with chronic tension-type headache (CTTH).
Methods
Ninety-nine people (27% men) with CTTH reported their pain on four different body charts representing the head and neck. Pain extent and frequency maps were obtained using customized software. Clinical features of headache, burden related to headache (Headache Disability Inventory [HDI]), anxiety and depression (Hospital Anxiety-Depression Scale [HADS]), and anxiety state/trait (State-Trait Anxiety Inventory [STAI]) levels were assessed. Pressure pain thresholds (PPT) were assessed over the temporalis muscle (trigeminal area), the cervical spine (extratrigeminal area), and the tibialis anterior muscle (distant pain-free area) to determine widespread pressure sensitivity. Associations between pain extent and all outcomes were analyzed.
Results
Pain extent showed significant positive associations with age (r = 0.221, P = 0.029) and burden of the headache (emotional: r = 0.213, P = 0.030; physical: r = 0.208, P = 0.039), but no other significant association was found.
Conclusions
Pain extent weakly correlated with older age as well as with higher emotional and physical burden of the headache in CTTH. In this population, there was no relationship between pain extent and PPT, indicating that larger pain areas were not associated with signs of central sensitization. Pain drawings can complement other clinical pain features for better characterization of CTTH, but further studies are needed.
Earlier studies suggest that pain extent, extracted from the patients' pain drawings, can help clinicians to identify people with central sensitization or worse clinical features. Our aim was to investigate possible associations between perceived pain extent and clinical pain features, burden of headache, psychological outcomes, and pressure sensitivity in people with chronic tension-type headache (CTTH).
Methods
Ninety-nine people (27% men) with CTTH reported their pain on four different body charts representing the head and neck. Pain extent and frequency maps were obtained using customized software. Clinical features of headache, burden related to headache (Headache Disability Inventory [HDI]), anxiety and depression (Hospital Anxiety-Depression Scale [HADS]), and anxiety state/trait (State-Trait Anxiety Inventory [STAI]) levels were assessed. Pressure pain thresholds (PPT) were assessed over the temporalis muscle (trigeminal area), the cervical spine (extratrigeminal area), and the tibialis anterior muscle (distant pain-free area) to determine widespread pressure sensitivity. Associations between pain extent and all outcomes were analyzed.
Results
Pain extent showed significant positive associations with age (r = 0.221, P = 0.029) and burden of the headache (emotional: r = 0.213, P = 0.030; physical: r = 0.208, P = 0.039), but no other significant association was found.
Conclusions
Pain extent weakly correlated with older age as well as with higher emotional and physical burden of the headache in CTTH. In this population, there was no relationship between pain extent and PPT, indicating that larger pain areas were not associated with signs of central sensitization. Pain drawings can complement other clinical pain features for better characterization of CTTH, but further studies are needed.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1093/pm/pnx047
- PMID 28387834
- Persistent URL
- https://sonar.ch/global/documents/279040
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