PMID- 31329227 OWN - NLM STAT- MEDLINE DCOM- 20210514 LR - 20210514 IS - 1526-4637 (Electronic) IS - 1526-2375 (Linking) VI - 21 IP - 7 DP - 2020 Nov 7 TI - Widespread Pressure Pain Sensitivity over Nerve Trunk Areas in Women with Frequent Episodic Tension-Type Headache as a Sign of Central Sensitization. PG - 1408-1414 LID - 10.1093/pm/pnz146 [doi] AB - OBJECTIVE: Previous studies reported the presence of widespread pressure pain sensitivity in patients with tension-type headache. However, most of the studies assessed pressure pain sensitivity over muscle tissue. Our aim was to investigate the difference in pressure pain sensitivity over musculoskeletal and nerve symptomatic and distant areas between women with frequent episodic tension-type headache (FETTH) and healthy subjects. METHODS: Thirty-two women with FETTH and 32 matched healthy women participated. Pressure pain threshold (PPT) was bilaterally assessed over several nerve trunks (greater occipital, median, radial, ulnar, common peroneal, tibialis posterior) and musculoskeletal structures (temporalis muscle, C5/C6 joint, tibialis anterior) by an assessor blinded to the subject's condition. A four-week headache diary was used to collect the intensity, frequency, and duration of headache. The Hospital Anxiety and Depression Scale was used to determine anxiety and depressive levels. RESULTS: Analysis of covariance found lower widespread and bilateral PPTs over all nerve trunks and musculoskeletal structures in women with FETTH pain (P < 0.001). No significant effect of anxiety and depressive levels on PPTs was found (all P > 0.222). PPT over the temporalis muscle was significantly negatively correlated with headache intensity. CONCLUSIONS: This study found widespread pressure pain hypersensitivity over both nerve trunks and musculoskeletal structures in women with FETTH, suggesting that the presence of central altered nociceptive processing is not just restricted to musculoskeletal areas, for example, muscles, but also pain evoked from directly provoking the nerve trunks by pressure. It is also possible that nerve tissue treatment could lead to a decrease in central sensitization and headache features. CI - (c) 2019 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Caamano-Barrios, Leandro H AU - Caamano-Barrios LH AD - Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Madrid, Spain. AD - Department of Physical Therapy, Escuela Universitaria Gimbernat Cantabria, Cantabria, Spain. FAU - Galan-Del-Rio, Fernando AU - Galan-Del-Rio F AD - Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain. FAU - Fernandez-de-Las-Penas, Cesar AU - Fernandez-de-Las-Penas C AD - Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain. AD - Catedra de Docencia, Clinica e Investigacion en Fisioterapia: Terapia Manual, Puncion Seca y Ejercicio Terapeutico, Universidad Rey Juan Carlos, Madrid, Spain. AD - CNAP, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark. FAU - Plaza-Manzano, Gustavo AU - Plaza-Manzano G AD - Department Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain. AD - Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos, Madrid, Spain. FAU - Arendt-Nielsen, Lars AU - Arendt-Nielsen L AD - CNAP, Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark. FAU - Ortega-Santiago, Ricardo AU - Ortega-Santiago R AD - Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Madrid, Spain. AD - Catedra de Docencia, Clinica e Investigacion en Fisioterapia: Terapia Manual, Puncion Seca y Ejercicio Terapeutico, Universidad Rey Juan Carlos, Madrid, Spain. LA - eng PT - Journal Article PL - England TA - Pain Med JT - Pain medicine (Malden, Mass.) JID - 100894201 SB - IM MH - Central Nervous System Sensitization MH - Female MH - Humans MH - Pain MH - *Pain Threshold MH - Pressure MH - *Tension-Type Headache OTO - NOTNLM OT - Nerve Trunks OT - Pressure Pain OT - Sensitization OT - Tension-Type Headache EDAT- 2019/07/23 06:00 MHDA- 2021/05/15 06:00 CRDT- 2019/07/23 06:00 PHST- 2019/07/23 06:00 [pubmed] PHST- 2021/05/15 06:00 [medline] PHST- 2019/07/23 06:00 [entrez] AID - 5536926 [pii] AID - 10.1093/pm/pnz146 [doi] PST - ppublish SO - Pain Med. 2020 Nov 7;21(7):1408-1414. doi: 10.1093/pm/pnz146.