Migraine Pain Location May Not Have Clinical Implications

The location of migraine pain may not be associated with psychiatric distress, emergency department visits, or healthcare use.

The location of migraine pain may not be associated with psychiatric distress, emergency department visits, or healthcare use, according to a study published in Pain Research and Management.

The study included participants with migraine who visited a tertiary headache clinic in 2011 (n=477). The researchers examined medical record information, including demographic data, pain location, handedness, comorbid psychiatric diagnoses, medical and emergency department visits, and use of selected headache medications.

In this cohort, 47.8% of participants (n=228) reported lateralized pain, 47.9% (n=107) of which was right sided compared with 28.5% (n=65) who reported left-sided pain (P =.001). Another 24.5% (n=56) reported unilateral pain with no side predominance.

With the exception of self-reported posttraumatic stress disorder (PTSD), no significant associations were established between left and right pain and measures of psychiatric distress, emergency department visits, or healthcare use.

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Although unilateral pain location can be helpful in diagnosing migraine, these results indicate that its absence does not rule out a diagnosis because more than half of patients with migraine have bilateral head pain.

“The statistically significant association of greater left- than right-sided head pain with PTSD may be spurious but could be explored in subsequent studies,” the researchers wrote.

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Reference

Loder E, Weizenbaum E, Giddon D. Migraine pain location and measures of healthcare use and distress: an observational study. [published online June 4, 2018]. Pain Res Manag. doi:10.1155/2018/6157982.