Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain

DOI: https://doi.org/10.1186/s10194- 017- 0753- y

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Abstract-Summary The prevalence of migraine with co-existing tension-type headache and neck pain is high in the general population.

The aim of this study was to investigate a) the prevalence of migraine with co- existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain com- pared to healthy controls, c) the perceived ability of persons with migraine and co- existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition.

Out of 148 persons with migraine, 100 (67%) suffered from co-existing tension-

type headache and neck pain.

Persons with migraine and co-existing tension-type headache and neck pain had lower level of physical activity and psychological well-being, higher level of per- ceived stress and poorer self-rated health compared to healthy controls.

Migraine with co-existing tension-type headache and neck pain was highly prev-

alent in a clinic-based sample.

Persons with migraine and co-existing tension-type headache and neck pain may require more individually tailored interventions to increase the level of physical activity, and to improve psychological well-being, perceived stress and self- rated health.

Extended: The prevalence of migraine in Europe is 15% [598], and persons with migraine often suffer from co-morbidities such as tension-type headache (TTH) and neck pain (NP).

The prevalence of migraine with co-existing TTH and NP differed from the population- based study by Ashina and others [599] that found a one-year prevalence of NP of 89.3% in persons suffering from migraine and co-existing TTH.

The aim of this study was to investigate a) the prevalence of migraine and co- existing TTH and NP in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing TTH and NP compared to healthy controls, c) the per- ceived ability of persons with migraine and co-existing TTH and NP to perform physical activity, and d) which among the three conditions (migraine, TTH or NP) is rated as the most burdensome condition.

Persons with migraine are in general very susceptible to stress [181, 600] and have higher levels of stress compared to headache-free individuals [601] which is in line with our findings.

Persons with migraine and co-existing TTH and NP reported significantly lower level of physical activity and psychological well-being; higher level of perceived stress, and poorer self-rated health than healthy controls.

Background This study focuses on persons with migraine and co-existing TTH and NP.

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There is very little literature on the characteristics of persons with migraine and

co-existing TTH and NP.

It is not known whether specific nonpharmacological treatments could be par-

ticularly helpful for persons with migraine and co-existing TTH and NP.

The aim of this study was to investigate a) the prevalence of migraine and co- existing TTH and NP in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing TTH and NP compared to healthy controls, c) the per- ceived ability of persons with migraine and co-existing TTH and NP to perform physical activity, and d) which among the three conditions (migraine, TTH or NP) is rated as the most burdensome condition.

Methods The following items were analysed in this study: perceived stress, self-rated health, the perceived ability to perform physical activity and rating of the most burdensome condition.

Perceived ability to perform physical activity was assessed by three items: “In the past four weeks, when having migraine/TTH/NP, how much has your ability to perform physical activity (physical activity or strength training) been reduced?”

Rating of the most burdensome condition was assessed by one item: “In the past

four weeks, to what extent does your migraine, TTH and NP generally affect you?

Low educational level is associated with reduced health and low level of physical activity [602], therefore, separate binary logistic regressions were performed with migraine and co-existing TTH and NP as the outcome variable and the following as covariates: Physical activity (low, moderate and high), psychological well-being (score ≤ 50, yes or no), perceived stress (low, moderate and high), and poor self- rated health (yes or no).

Results Only 11% suffered from migraine only (n = 16), 11% suffered from migraine and co-existing TTH (n = 16), and 11% had migraine and co-existing NP (n = 16).

For persons with migraine and co-existing TTH and NP, the ability to perform physical activity was highly reduced because of migraine (median score of 9 on a rating scale from 0–10), moderately reduced because of TTH (median 5) and less reduced because of NP (median 3).

Almost half of the persons with migraine and co-existing TTH and NP (48%)

rated migraine as the most burdensome of the three conditions.

Migraine and TTH were rated as equally burdensome by 6%, all three conditions

as equally burdensome by 3% and TTH and NP by 3%.

Discussion This is the first study to investigate the prevalence of migraine and co-existing TTH and NP in a clinical migraine population and to evaluate physical activity, psycho- logical well-being, perceived stress and self-rated health in this subset of persons with migraine.

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The characteristics of the participants with migraine and co-existing TTH and NP reflect the findings of other studies on the impact of migraine on psychological well-being, an association with increased stress and poor self-rated health [601–604].

Decreased psychological well-being, high perceived stress and low self-rated health among those with migraine and co-existing TTH and NP suggest conditions that may make it more difficult to motivate this group to increase their levels of physical activity.

Conclusions Persons with migraine and co-existing TTH and NP reported significantly lower level of physical activity and psychological well-being; higher level of perceived stress, and poorer self-rated health than healthy controls.

Persons with migraine and co-existing TTH and NP reported a reduced ability to perform physical activity owing to all three conditions with migraine as the most burdensome condition followed by TTH and NP.

Persons with migraine and co-existing TTH and NP may require more focused

interventions to increase physical activity.

Acknowledgement A machine generated summary based on the work of Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda; Nielsen, Trine; Sloth, Louise Bönsdorff; Jensen, Rigmor Højland; Gard, Gunvor. 2017  in The Journal of Headache and Pain

The Association Between Dietary Acid Load and Odds of Migraine: A Case–Control Survey