Pericranial muscle tenderness and pressure-pain threshold in the temporal region during common migraine

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Abstract
Twenty-six patients were examined during attacks of common migraine as well as during headache-free interval. Pericranial tenderness was scored blindly by a systematic manual palpation on both occasions by the same observer. Pressure-pain threshold (PPT) in a fixed location over the temporal muscle was determined by the use of a pressure algometer. A 28% increase in total tenderness score was observed during attacks (P < 0.01). During unilateral attacks, tenderness scores were significantly higher on the ipsilateral side as compared to the contralateral (P < 0.01). A positive correlation was observed between tenderness on the two sides P < 0.05) and the two occasions (P < 0.01). PPT showed no changes during migraine attacks and there was no difference in PPT between the ipsilateral and contralateral side. A positive correlation was observed between PPT on the two sides and the two occasions (P < 0.01). PPT was not correlated to the tenderness scores obtained by manual palpation. The absence of a decrease in PPT and the presence of several tender areas in multiple regions, particularly where pain was spontaneously reported to be located, suggest the presence of either a multi-focal peripheral pathological process or referred pain from other structures in the head and neck region.