Migraine is not just a headache

the symptoms of migraine are strongly associated with headache – which can often be disabling – but are not limited to just that. Among other repercussions, migraine patients may also experience pain in the neck and even in the muscles of the shoulders. This is what a study published in cephalalgiathe official magazine of International Headache Society (IHS)which evaluated the trapezius muscles (which are in the shoulder region) of people with migraine, using MRI scans.

In the study, 21 individuals with migraine and 22 people with no history of the disease were evaluated to establish the comparison. In the results, the researchers found that all those with migraine had myofascial trigger points in the trapezius muscle, in addition to signs that indicated inflammatory processes in the musculature.

“Migraine is a common complaint and is often associated with other pain. The anamnesis of these patients includes the investigation of pain in the shoulders, face and cervical spine, almost always confirmed by them”, says neurologist Paulo Faro, headache specialist and member of the Brazilian Headache Society.

Faro points out that cervicalgia (neck pain), for example, is frequent in patients with migraine: “There is evidence of inflammatory processes in the trapezius muscle and this is well seen in clinical practice. The study in question reinforced this finding.”

In the study, among those who had muscle changes, there were no significant differences regarding age, sex, body mass index or number of myofascial trigger points.

“However, what was found was that all patients with migraine had these points in the trapezius muscles, significantly more when compared to the control group, that is, those without the condition”, continues the specialist. “This research is in line with evidence that reveals a peripheral inflammatory process triggered by migraine, proving, once again, that the disease is not just a simple headache.”

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After all, what is the relationship?

Faro explains that the trigeminal-cervical complex is the key structure to understand the phenomenon that explains the relationship between migraine and muscle pain. “There is a connection of nerves that carry the information of pain in the head and shoulders. In a heavy migraine, for example, branches of the trigeminal nerve, responsible for the sensitivity of the head region, activate the cervical nerves, stimulating them and also stimulating the muscles in the region, which become sensitized”, he explains.

The doctor comments that, in cases of frequent migraines (daily or weekly), the provocation of repetitive stimuli makes the muscles of the face, neck and shoulders increasingly sensitive, causing the person to feel spontaneous pain.

In the research, the MRI results were divided into sequences and each one showed an alteration in a given structure studied. In the sequence used, the hyperintense inflammatory process was demonstrated (that is, clearer in the image), suggesting that that region is inflamed. “

Activated migraine causes an inflammatory process in the trapezius musculature, which was the target muscle of the study. However, other muscles also show this inflammation”, explains Faro. Future work may validate this finding in larger samples, but the researchers believe this inflammatory factor may have the potential to become a viable biomarker.

*This content was produced by Agência Einstein.