Comorbid pain and migraine chronicity

Abstract

Objective:To identify patterns of noncephalic pain comorbidity in people with episodic migraine (EM; <15 headache-days per month) and chronic migraine (CM; ≥15 headache-days per month) and to examine whether the presence of noncephalic pain is an indicator for the 3-month onset or persistence of CM.Methods:Data from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study, a prospective, web-based study with cross-sectional modules embedded in a longitudinal design, were analyzed at baseline and the 3-month follow-up. Relationships between the number of noncephalic pain sites and 3-month onset of CM or persistent CM were assessed.Results:Of 8,908 eligible respondents, 8,139 (91.4%) had EM and 769 (8.6%) had CM at baseline. At 3 months, the incidence of CM among those with baseline EM was 3.4%. When adjusted for demographics and headache-day frequency, the odds of CM onset among those with baseline EM increased by 30% (95% confidence interval [CI] 1.21–1.40, p < 0.001) for each additional noncephalic pain site at baseline. Among those with CM at baseline, 50.1% had persistent CM at the 3-month follow-up. After adjustment for demographics, individuals with CM were 15% (95% CI 1.07–1.25, p < 0.001) more likely to have persistent CM for each additional noncephalic pain site at baseline.Conclusions:These results suggest that noncephalic pain may be a marker for headache chronicity that could be used to identify people with EM at risk of the onset of CM and people with CM at risk of persistent CM.

Factors associated with acute medication overuse in people with migraine: results from the 2017 migraine in America symptoms and treatment (MAST) study

“…Other MAST Study results differ from those previously reported. For example, the rate of allodynia in the total sample (~ 40.0%) is similar to some previous studies [ 35 ] but lower than the 50% to 80% found in other studies [ 31 , 36 – 41 ]. We are not sure what accounts for the variation in rates of allodynia among studies using the ASC-12.…”

Comorbid and co-occurring conditions in migraine and associated risk of increasing headache pain intensity and headache frequency: results of the migraine in America symptoms and treatment (MAST) study

“…A large and ever expanding range of comorbidities have been associated with migraine, including irritable bowel disease, atrial fibrillation, Crohn's disease, personality disorders, sleep apnea, fibromyalgia, Raynaud's disease, and many more conditions that were not included in the MAST survey due to limitations of space and an attempt to minimize respondent fatigue [36]. In a previous study using a similar methodology (the CaMEO Study), noncephalic pain was a marker for the new onset of CM among a sample of people with EM [71]. Pain was not fully addressed in this analysis and other pain conditions may be part of the multi-comorbidity profile for some MAST Study respondents.…”

Health technology assessment for the acute and preventive treatment of migraine: A position statement of the International Headache Society

“…The possible direct costs of migraine include medication for acute and preventive treatment; management of treatment related AEs; outpatient therapy; office visit(s) with general practitioners, non-neurologic specialists (internists, paediatricians, ob-gyn), neurologists, psychologists; telehealthcare visits or consultations; diagnostic evaluation and management of treatment-emergent side effects; home visits by the medical emergency service (available in some countries); emergency room visits; physical therapy; in-patient therapy; and management of comorbid conditions ( 57 – 61 ).…”