Reduction of neck pain severity in patients with medication-overuse headache.

IF 7.3 1区医学 Q1 CLINICAL NEUROLOGY Journal of Headache and Pain Pub Date : 2024-11-04 DOI:10.1186/s10194-024-01876-2

Yooha Hong, Hong-Kyun Park, Mi-Kyoung Kang, Sun-Young Oh, Jin-Ju Kang, Heui-Soo Moon, Tae-Jin Song, Mi Ji Lee, Min Kyung Chu, Soo-Jin Cho

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Abstract

Background: Neck pain and primary headache disorders are highly prevalent in populations and clinical cohorts. Medication-overuse headache (MOH) is a treatable secondary headache, mainly developing in migraine sufferers, that accounts for the majority of patients presenting to headache clinics. Nevertheless, the association between neck pain and MOH has not been reported. This study evaluated the prevalence and clinical course of neck pain in patients with MOH before and after MOH treatment.

Methods: We analyzed 635 MOH patients enrolled in a nationwide, prospective, multicenter MOH registry. Demographics and clinical data were collected at baseline and 3 months to evaluate changes in the status and severity of neck pain and headache. Severity of neck pain was graded into 4 groups, and severe neck pain was defined as grade 3 or 4.

Results: Among 635 patients with MOH, 366 (57.6%) reported neck pain at baseline. MOH patients with neck pain had an earlier onset of their primary headache disorder (23.4 ± 12.7 vs. 26.2 ± 13.3 years, p = 0.007). Although monthly headache days were comparable between the patients with neck pain and those without neck pain, the neck pain group had higher levels of anxiety (7.4 ± 5.8 vs. 6.4 ± 5.4, p = 0.017), more severe cutaneous allodynia (2.4 ± 3.3 vs. 1.8 ± 3.0, p = 0.038), and poorer quality of life (171.7 ± 70.4 vs. 184.0 ± 68.9, p = 0.029). At 3 months, 456 (71.8%) were followed-up, and 257 (56.4%) were recovered from MOH. Compared to the baseline, the proportion of severe neck pain (40.4% vs. 19.4%, p < 0.001) was decreased. The proportion of severe neck pain was much lower in patients with recovery from MOH compared to those without (4.7% vs. 15.1%, p < 0.001).

Conclusions: Neck pain in MOH patients was associated with earlier onset of headache, higher levels of anxiety and allodynia, and poorer quality of life. Improvement in neck pain improvement was linked to recovery from MOH. These findings suggest the potential importance of integrating and management of neck pain into clinical practice for MOH.

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减轻药物滥用性头痛患者颈部疼痛的严重程度。

背景：颈痛和原发性头痛疾病在人群和临床队列中发病率很高。药物滥用性头痛（MOH）是一种可治疗的继发性头痛，主要发生在偏头痛患者身上，占头痛门诊就诊患者的大多数。然而，颈部疼痛与 MOH 之间的关联尚未见报道。本研究评估了MOH患者在MOH治疗前后颈部疼痛的发生率和临床过程：我们分析了全国性、前瞻性、多中心 MOH 登记处登记的 635 名 MOH 患者。我们收集了基线和3个月的人口统计学和临床数据，以评估颈部疼痛和头痛的状况和严重程度的变化。颈部疼痛的严重程度分为 4 级，严重颈部疼痛被定义为 3 级或 4 级：在635名MOH患者中，366人（57.6%）在基线时报告有颈部疼痛。有颈部疼痛的 MOH 患者的原发性头痛发病时间较早（23.4 ± 12.7 年 vs. 26.2 ± 13.3 年，p = 0.007）。虽然颈痛患者与非颈痛患者的每月头痛天数相当，但颈痛组的焦虑程度更高（7.4 ± 5.8 vs. 6.4 ± 5.4，p = 0.017），皮肤异感更严重（2.4 ± 3.3 vs. 1.8 ± 3.0，p = 0.038），生活质量更差（171.7 ± 70.4 vs. 184.0 ± 68.9，p = 0.029）。3个月后，456人（71.8%）接受了随访，257人（56.4%）从MOH中康复。与基线相比，严重颈部疼痛的比例（40.4% vs. 19.4%，p 结论：颈部疼痛是MOH患者的常见症状：MOH患者的颈部疼痛与较早出现头痛、较高程度的焦虑和异感以及较差的生活质量有关。颈部疼痛的改善与 MOH 的恢复有关。这些研究结果表明，将颈部疼痛纳入MOH的临床实践并对其进行管理具有潜在的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Headache and Pain 医学-临床神经学

CiteScore

11.80

自引率

13.50%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.