Chronic Musculoskeletal Pain Travels With Chronic Daily Headache

LONDON – Chronic musculoskeletal complaints and chronic daily headache share a bidirectional causal relationship in which patients with either condition are predisposed over time to develop the other one, according to Dr. Lars J. Stovner.

This key finding from an impressively large, longitudinal, population-based Norwegian study has importance both for frontline clinicians as well as academic researchers, he said at the European Headache and Migraine Trust International Congress.

"From a practical point of view, one can say that if one has a patient with one of these common complaints, one should try hard to treat it not only to bring relief to the patient but to prevent the development of the other condition," said Dr. Stovner of the Norwegian University of Science and Technology, Trondheim.

The new observation of a bidirectional relationship between chronic musculoskeletal pain and chronic daily headache may also have import in terms of understanding the relevant pathophysiology. It suggests the disorders may share a common underlying cause.

"It says that chronic pain in the body is probably very much related to chronic headache. As we’ve heard elsewhere at this conference, they are both basically brain disorders," he continued.

Dr. Stovner presented data from two consecutive surveys conducted 11 years apart as part of the Nord-Trøndelag Health Study (HUNT). HUNT 2 included 51,383 adults queried in 1995-1997, of whom 26,197 completed the HUNT 3 questions regarding headache and chronic musculoskeletal pain at follow-up in 2006-2008.

Participants with chronic musculoskeletal complaints at baseline in HUNT 2 proved to have a 1.8-fold increased risk of developing chronic daily headache 11 years later in HUNT 3 compared with subjects without baseline chronic musculoskeletal pain, in a multivariate analysis adjusted for the known potential confounders of age, sex, anxiety, depression, and socioeconomic status.

Moreover, subjects with chronic daily headache but not chronic musculoskeletal pain in HUNT 2 had an identical adjusted 1.8-fold increased risk of developing chronic musculoskeletal pain in HUNT 3. The risk climbed to 2.7-fold when the analysis was restricted to individuals with widespread chronic musculoskeletal complaints in HUNT 3.

"Chronic daily headache and chronic musculoskeletal complaints are enormous public health problems. This is a huge population-based prospective study running for longer than 10 years," commented session cochair Dr. Zaza Katsarava of Evangelist Hospital in Unna, Germany. "The results clearly show there are no separate physiologic baskets for migraine and back pain; they are both part of an entire pain matrix that is impaired."

The HUNT study is supported by Norwegian governmental research funds. Dr. Stovner reported having no relevant financial conflicts.

LONDON – Chronic musculoskeletal complaints and chronic daily headache share a bidirectional causal relationship in which patients with either condition are predisposed over time to develop the other one, according to Dr. Lars J. Stovner.

This key finding from an impressively large, longitudinal, population-based Norwegian study has importance both for frontline clinicians as well as academic researchers, he said at the European Headache and Migraine Trust International Congress.

"From a practical point of view, one can say that if one has a patient with one of these common complaints, one should try hard to treat it not only to bring relief to the patient but to prevent the development of the other condition," said Dr. Stovner of the Norwegian University of Science and Technology, Trondheim.

The new observation of a bidirectional relationship between chronic musculoskeletal pain and chronic daily headache may also have import in terms of understanding the relevant pathophysiology. It suggests the disorders may share a common underlying cause.

"It says that chronic pain in the body is probably very much related to chronic headache. As we’ve heard elsewhere at this conference, they are both basically brain disorders," he continued.

Dr. Stovner presented data from two consecutive surveys conducted 11 years apart as part of the Nord-Trøndelag Health Study (HUNT). HUNT 2 included 51,383 adults queried in 1995-1997, of whom 26,197 completed the HUNT 3 questions regarding headache and chronic musculoskeletal pain at follow-up in 2006-2008.

Participants with chronic musculoskeletal complaints at baseline in HUNT 2 proved to have a 1.8-fold increased risk of developing chronic daily headache 11 years later in HUNT 3 compared with subjects without baseline chronic musculoskeletal pain, in a multivariate analysis adjusted for the known potential confounders of age, sex, anxiety, depression, and socioeconomic status.

Moreover, subjects with chronic daily headache but not chronic musculoskeletal pain in HUNT 2 had an identical adjusted 1.8-fold increased risk of developing chronic musculoskeletal pain in HUNT 3. The risk climbed to 2.7-fold when the analysis was restricted to individuals with widespread chronic musculoskeletal complaints in HUNT 3.

"Chronic daily headache and chronic musculoskeletal complaints are enormous public health problems. This is a huge population-based prospective study running for longer than 10 years," commented session cochair Dr. Zaza Katsarava of Evangelist Hospital in Unna, Germany. "The results clearly show there are no separate physiologic baskets for migraine and back pain; they are both part of an entire pain matrix that is impaired."

The HUNT study is supported by Norwegian governmental research funds. Dr. Stovner reported having no relevant financial conflicts.

LONDON – Chronic musculoskeletal complaints and chronic daily headache share a bidirectional causal relationship in which patients with either condition are predisposed over time to develop the other one, according to Dr. Lars J. Stovner.

This key finding from an impressively large, longitudinal, population-based Norwegian study has importance both for frontline clinicians as well as academic researchers, he said at the European Headache and Migraine Trust International Congress.

"From a practical point of view, one can say that if one has a patient with one of these common complaints, one should try hard to treat it not only to bring relief to the patient but to prevent the development of the other condition," said Dr. Stovner of the Norwegian University of Science and Technology, Trondheim.

The new observation of a bidirectional relationship between chronic musculoskeletal pain and chronic daily headache may also have import in terms of understanding the relevant pathophysiology. It suggests the disorders may share a common underlying cause.

"It says that chronic pain in the body is probably very much related to chronic headache. As we’ve heard elsewhere at this conference, they are both basically brain disorders," he continued.

Dr. Stovner presented data from two consecutive surveys conducted 11 years apart as part of the Nord-Trøndelag Health Study (HUNT). HUNT 2 included 51,383 adults queried in 1995-1997, of whom 26,197 completed the HUNT 3 questions regarding headache and chronic musculoskeletal pain at follow-up in 2006-2008.

Participants with chronic musculoskeletal complaints at baseline in HUNT 2 proved to have a 1.8-fold increased risk of developing chronic daily headache 11 years later in HUNT 3 compared with subjects without baseline chronic musculoskeletal pain, in a multivariate analysis adjusted for the known potential confounders of age, sex, anxiety, depression, and socioeconomic status.

Moreover, subjects with chronic daily headache but not chronic musculoskeletal pain in HUNT 2 had an identical adjusted 1.8-fold increased risk of developing chronic musculoskeletal pain in HUNT 3. The risk climbed to 2.7-fold when the analysis was restricted to individuals with widespread chronic musculoskeletal complaints in HUNT 3.

"Chronic daily headache and chronic musculoskeletal complaints are enormous public health problems. This is a huge population-based prospective study running for longer than 10 years," commented session cochair Dr. Zaza Katsarava of Evangelist Hospital in Unna, Germany. "The results clearly show there are no separate physiologic baskets for migraine and back pain; they are both part of an entire pain matrix that is impaired."

The HUNT study is supported by Norwegian governmental research funds. Dr. Stovner reported having no relevant financial conflicts.