PO-17 | A clinical guide to assess and manage altered pain sensitivity and cervical musculoskeletal impairments migraine patients. Part 1: Assessment and profiling

Stefano Di Antonio,^1,2 Lars Arendt-Nielsen,¹ Matteo Castaldo^1,3 | ¹Department of Health Science and Technology, Center for Pain and Neuroplasticity (CNAP), SMI, School of Medicine, Aalborg University, Aalborg, Denmark; ²Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa; ³Department of Medicine and Surgery, Clinical Psychology, University of Parma, Italy

Background: Migraine is a complex neurological disorder characterized by different signs and symptoms, and patients often present with an altered pain sensitivity and cervical musculoskeletal impairments^1,2. Therefore, in the management of migraine patients the assessment and eventually a specific treatment of these aspects should be included. This abstract provides evidence-based guidance on assessment techniques and clinical reasoning strategies to help clinicians effectively evaluate and interpret these aspects in clinical practice.

Methods: A review of the current literature has been performed and the results reported in this abstract are based on a recently published manuscript^1,2. This abstract offers evidence-based guidance on how to perform and interpret assessment tests to effectively evaluate cervical musculoskeletal impairments and altered pain sensitivity in migraine patients.

 Results: This abstract provides a detailed explanation of how to perform a subjective examination (anamnesis) and an objective examination (physical examination): each test is described in detail, along with reference cut-off values that help identify the presence of these impairments. Based on the assessment results, each migraine patient was categorized into a specific subgroup according to the presence of cervical musculoskeletal impairments and/or altered pain sensitivity.

Conclusion: The ability to accurately assess increased pain sensitivity and cervical musculoskeletal impairments will enable clinicians to profile migraine patients based on these characteristics and implement a personalized treatment approach.

References

1.  Castaldo M, Arendt-Nielsen L, Di Antonio S. A clinical guide for physiotherapists to assess and manage cervical musculoskeletal impairment and pain sensitivity in migraine patients. J Man Manip Ther. 2025 May 18:1-18. 
2. Di Antonio S, Arendt-Nielsen L, Castaldo M. Cervical musculoskeletal impairments and pain sensitivity in migraine patients. Musculoskelet Sci Pract. 2023 Aug;66:102817.