Predictors of Disability in Migraineurs Referred to a Tertiary Clinic: Neck Pain, Headache Characteristics, and Coping Behaviors

• Published in: Headache 2008-04, Vol.48 (4), p.523-528
• Main Authors: Ford, Sutapa, Calhoun, Anne, Kahn, Kevin, Mann, John, Finkel, Alan
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological - physiology; Adult; Biological and medical sciences; coping; disability; Disability Evaluation; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Male; Medical sciences; migraine; Migraine Disorders - complications; Migraine Disorders - physiopathology; Migraine Disorders - psychology; Nausea - etiology; neck pain; Neck Pain - etiology; Nervous system (semeiology, syndromes); Neurology; Pain Clinics; Photophobia - etiology; Retrospective Studies; Vascular diseases and vascular malformations of the nervous system
• ISSN: 0017-8748; 1526-4610
• DOI: 10.1111/j.1526-4610.2008.00859.x

Objective.— The aim of this retrospective study was to determine if neck pain, select headache characteristics, and migraine‐related coping response predicted disability in migraineurs referred to a tertiary headache clinic. Methods.— Patients seeking treatment at a neurology‐based headache clinicwere included if they met diagnostic criteria for migraine with or without aura according to the International Headache Society (1.1, 1.2). Subjects completed a self‐report headache history form and a detailed headache and neurologic examination. The headache history form assessed: 1)weekly headache frequency; 2) number ofweekly severe headaches; 3) presence of migrainerelated neck pain; 4) photophobia; 5) phonophobia; 6) headache duration; 7) vomiting; 8) monthly headache‐free days; and 9) behavioral coping style. Disability was assessed using a self‐report inventory (HIT‐6). Results.— Self‐reported headache severity, frequency, and headache‐free days were strongly associated with disability. The presence of neck pain during migraine and one's coping response to migraine significantly predicted disability independent of headache characteristics. Conclusions.— These data suggest the need for prospective research exploring the causal mechanisms by which neck pain and coping response influence disability and underscores the importance of multidisciplinary approaches to headache management.