The Migraine World Summit Summary: Day 5

Day 5

Gretchen Tietjen: Body pain, Allodynia & Fibromyalgia

Migraine & Body – Body aches & hair hurts

Allodynia

- Pain without painful stimulus

- “Central sensitization”

- Examples include; combing hair, putting on glasses or earrings and pain whilst washing hair (sensitivity to heat or cold)

- Light touch can be extremely painful

- 80% will say they have experienced this with a migraine

Chronic migraine – can experience allodynia outside of an attack as well

Migraine comorbid conditions

1. Endometriosis (nerves to areas of endometriosis growths)

2. IBS

3. Interstitial cystitis

4. Chronic fatigue syndrome

5. Fibromyalgia (not problems with muscle itself – problem with nerves to muscles)

Central sensitization – trigeminal nerves (sinus, face & head) – explains why some people think they are experiencing sinusitis.

Allodynia sufferers

-        More likely to smoke

-        Higher BMI

-        More than one pain condition

Migraine and body pain- is it fibro?

-        Trigger points on the body; back of shoulders, spine, hips, elbows, legs. Sensitive on specific body points.

What can help?

1. Physical therapy

2. Exercise

3. Water therapy

4. CBT

5. Tai Chi

6. Mindfulness

7. Yoga.

8. Physio/ Psychologists

Medications

1. Fibro – duloxetine, pregabalin, Cymbalta (Approved by FDA)

2. SSRI (am) + Tricyclic antidepressant (amitriptyline) (pm) – combination of two can work well together. Anti-depressants can work well for migraine too.

3. Antivirals possibly for fibromyalgia

If you are able to stop the pain in your body – Allodynia usually calms down as well.

Communication between different doctors is very important. Brief your new doctor. Tell neuro what is happening with gynae for example. Accessing your notes from different areas can be difficult.

Neuro can make referrals to other specialists where required for example to a physio or rheumatologist.