Daily stress and pain sensitivity in chronic tension-type headache sufferers

The aim was to examine interactions between daily stress, pain sensitivity, and headache activity in Chronic Tension-Type Headache sufferers. We measured daily hassles, pericranial muscle tenderness, pressure pain threshold at finger, headache history (years of headache) and prospective headache activity (in a two-week clinical diary), in headache sufferers and healthy Controls. Headache sufferers bad increased daily hassles scores, increased muscle tenderness, and decreased pain threshold compared to Controls. Daily hassles were correlated with increased muscle tenderness and reduced pain threshold in the CTH group. In regression analyses, daily hassles predicted muscle tenderness when accounting for headache history, headache severity and pain threshold. Muscle tenderness and daily hassles predicted headache severity when accounting for headache history and pain threshold. Muscle tenderness predicted pain threshold when accounting for headache history, headache severity and daily hassles. The results indicate daily stress is related to increased pain sensitivity and headache activity in Chronic Tension-Type Headache sufferers, accounting for significant variance in these factors additional to that accounted for by clinical factors (headache history and severity). Although only correlational, the results support the proposition that daily stress affects Chronic Tension-Type Headache through hyperalgesic effects on already sensitized pain pathways in headache sufferers. Copyright (c) 2007 John Wiley & Sons, Ltd.