The clinical presentation of migraine according to stratification based on the presence of neck pain during cervical spine palpation: a cross-sectional study

Abstract

Neck pain is a symptom present in more than 70% of individuals diagnosed with migraine. It is already known that individuals with self-reported neck pain have more severe clinical presentations when compared to individuals without neck pain. However, it is not yet known how the clinical presentations differs when individuals are stratified through palpation of the upper cervical spine. Objective: To evaluate the level of cutaneous allodynia severity, neck pain disability, migraine-related disability, pressure pain threshold and upper cervical mobility in patients diagnosed with migraine, following the stratification of these migraineurs using a pain reproduction test during palpation of the upper cervical spine. Methods: 63 women, between 18 and 65 years, diagnosed with migraine and cervical pain will be recruited. Patients will be stratified into three groups according to results from the upper cervical spine palpation test: without pain, with local pain and with pain referred to the head. They will answer the HIT-6 TM questionnaire to assess the headache-related disability, the NDI to assess neck pain disability, and the ASC-12 to assess cutaneous allodynia. In addition, volunteers will perform the FRT to assess upper cervical mobility and the pressure pain threshold to assess muscular sensitization. Descriptive data will be analyzed using mean and standard deviation. The results of the HIT-6TM , ASC-12, and NDI questionnaires and the range of motion of the upper cervical spine and the pressure pain threshold will be compared between groups using the ANOVA test followed by the post-hoc Bonferroni test. Expected results: Patients in the group with neck pain referred to the head on palpation are expected to have a worse clinical presentation, with cutaneous allodynia, neck and migraine-related disability, lower pressure pain threshold and upper neck hypomobility. (AU)