The Significance of Pain Drawing as a Screening Tool for Cervicogenic Headache and Associated Symptoms in Chronic Fatigue, 2022, Bernhoff et al

Discussion in 'ME/CFS research' started by Wyva, Aug 27, 2022.

  1. Wyva

    Wyva Senior Member (Voting Rights)

    Budapest, Hungary
    Purpose: Patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) present with a broad spectrum of symptoms, including headache. A simple, yet powerful tool – the pain drawing identifies essential aspects such as pain distribution. The aim with this study was to 1) evaluate the significance of pain drawing as a screening tool for cervicogenic headache using a predefined C2 pain pattern, 2) assess whether there was an association between dizziness/imbalance and a C2 pain pattern, and 3) compare subgroups according to the pain drawing with respect to pain characteristics and quality of life.

    Patients and Methods: Pain drawings and clinical data from 275 patients investigated for ME/CFS were stratified into: 1) cervicogenic headache as determined by a C2 pain pattern, 2) headache with no C2 pain pattern, and 3) no headache. For inference logistic regression presented with odds ratios (OR) and 95% confidence intervals (95% CI) and Kruskal–Wallis test were applied.

    Results: One hundred sixteen participants (42%) were stratified to the group for which the pain drawing corresponded to the C2 pain pattern, thus indicating putative cervicogenic origin of the headache. Dizziness/imbalance was strongly associated with a C2 pain pattern; OR 6.50 ([95% CI 2.42– 17.40] p ˂ 0.00), whereas this association was non-significant for patients with headache and no C2 pain pattern. Those demonstrating a C2 pain pattern reported significantly higher pain intensity (p = 0.00) and greater pain extent (p = 0.00) than the other groups, and lower health-related quality of life (p = 0.00) than the group with no headache.

    Conclusion: For patients with chronic fatigue who present with a C2 pain pattern (interpreted as cervicogenic headache) the pain drawing seems applicable as a screening tool for signs associated with neuropathic and more severe pain, dizziness and reduced quality of life as detection of these symptoms is essential for targeted treatment.

    Open access:
    JemPD, Peter Trewhitt and Trish like this.
  2. Arnie Pye

    Arnie Pye Senior Member (Voting Rights)

    I completely misunderstood "pain drawing" before I looked at the actual paper.

    If you google "drawings representing pain" that was what I expected.

    A lot of the kind of things I was thinking of aren't something I would want to post. But this one is innocuous enough, and partly represents what I had in mind:

  3. TiredSam

    TiredSam Committee Member

    I had the same problem the last time a doctor said they needed to draw my blood. I was looking around for the red crayon when suddenly someone stuck a needle in me.
    Grigor, shak8, Arnie Pye and 2 others like this.

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