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

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 clini...

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Main Authors: 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
Format: Article
Language:English
Published: BMC 2024-11-01
Series:The Journal of Headache and Pain
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Online Access:https://doi.org/10.1186/s10194-024-01876-2
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author 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
author_facet 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
author_sort Yooha Hong
collection DOAJ
description 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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spelling doaj-art-138fd2f8345a402089e4bf5c4d4c12b92024-11-10T12:35:15ZengBMCThe Journal of Headache and Pain1129-23772024-11-012511910.1186/s10194-024-01876-2Reduction of neck pain severity in patients with medication-overuse headacheYooha Hong0Hong-Kyun Park1Mi-Kyoung Kang2Sun-Young Oh3Jin-Ju Kang4Heui-Soo Moon5Tae-Jin Song6Mi Ji Lee7Min Kyung Chu8Soo-Jin Cho9Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of MedicineDepartment of Neurology, Inje University Ilsan Paik Hospital, Inje University College of MedicineDepartment of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of MedicineDepartment of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of MedicineDepartment of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of MedicineDepartment of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineDepartment of Neurology, Seoul Hospital, Ewha Womans University College of MedicineDepartment of Neurology, Seoul National University Hospital, Seoul National University College of MedicineDepartment of Neurology, Severance Hospital, Yonsei University College of MedicineDepartment of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of MedicineAbstract 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.https://doi.org/10.1186/s10194-024-01876-2Neck painMedication overuse headacheMigraineDisability
spellingShingle 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
Reduction of neck pain severity in patients with medication-overuse headache
The Journal of Headache and Pain
Neck pain
Medication overuse headache
Migraine
Disability
title Reduction of neck pain severity in patients with medication-overuse headache
title_full Reduction of neck pain severity in patients with medication-overuse headache
title_fullStr Reduction of neck pain severity in patients with medication-overuse headache
title_full_unstemmed Reduction of neck pain severity in patients with medication-overuse headache
title_short Reduction of neck pain severity in patients with medication-overuse headache
title_sort reduction of neck pain severity in patients with medication overuse headache
topic Neck pain
Medication overuse headache
Migraine
Disability
url https://doi.org/10.1186/s10194-024-01876-2
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