Self-administered pain-relieving manoeuvres in primary headaches.
We investigated the use of self-administered pain-relieving manoeuvres on a sample of 400 patients with primary headaches--represented by an even distribution of migraine without aura (MO), migraine with aura (MA), episodic tension-type headache (TH), and cluster headache (CH)--consecutively seen at Padua and Parma Headache Centres. Manoeuvres on various regions of the head were used by 258 patients (65% of the cases). The most applied procedures were: compression (114 out of 382 manoeuvres; 30%), application of cold (27%), massage (25%) and application of heat (8%). A significant (P < 0.001) relationship was found between headache diagnoses and type of manoeuvre. In MO patients the application of cold (38% of the manoeuvres) and compression (36%), used mainly on the forehead and temples, prevailed; compression, mainly on the temples, was the most frequent procedure (44%) in MA patients. Massage on the temples and nape was the predominant manoeuvre (43%) in TH patients, whereas in the CH group, which more often required heterogeneous procedures, none of the above-mentioned manoeuvres was prevalent. Compression, as a diagnostic criterion for MO, had a sensitivity of 33% and a specificity of 86%; for the application of cold the figures were 36% and 84%, respectively. Massage had a sensitivity of 33% and a specificity of 80% for TH. The efficacy of the self-administered manoeuvres in reducing pain was scarce. Only 8% of the manoeuvres, in fact, resulted in a good or excellent pain control. Moreover, the efficacy of the manoeuvre was often momentary, wearing off when the manoeuvre stopped. In spite of this, 46% of the subjects used the manoeuvres constantly, at each attack.
Zanchin
G
G
Department of Neurology, University of Padua, Padua, Italy. zangio@ux1.unipd.it
Maggioni
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Granella
F
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Rossi
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P
Falco
L
L
Manzoni
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GC
D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003080:Cold Temperature; D005260:Female; D006261:Headache / Q000523:psychology / Q000628:therapy*; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods; D008875:Middle Aged; D012648:Self Care / Q000379:methods*; D018709:Statistics, Nonparametric