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, 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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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.