PO-18 | A clinical guide to assess and manage altered pain sensitivity and cervical musculoskeletal impairments migraine patients. Part 2: individualised treatment

Matteo Castaldo,^1,2 Lars Arendt-Nielsen,¹ Stefano Di Antonio^1,3 | ¹Department of Health Science and Technology, Center for Pain and Neuroplasticity (CNAP), SMI, School of Medicine, Aalborg University, Aalborg, Denmark; ²Department of Medicine and Surgery, Clinical Psychology, University of Parma; ³Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, 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 characteristics should be included. This abstract provides evidence-based guidance on the clinical reasoning and individualized treatment approach, aiming to help clinicians in the management of 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 is the second in a series; the first part focused on how to perform and interpret assessment techniques for evaluating cervical musculoskeletal impairments and altered pain sensitivity in migraine patients. This second part offers evidence-based guidance on how to manage migraine patients in an individualized manner, based on the findings of the assessment.

Results: This abstract provides a detailed explanation of how to manage the eventual presence of cervical musculoskeletal impairments and altered pain sensitivity in patients with migraine. The clinical reasoning behind the identification of distinct subgroups of migraine patients according to the presence of cervical musculoskeletal impairments and/or altered pain sensitivity is reported. Specific treatment techniques used for each migraine subgroup are explained in detail.

Conclusion: An individualized treatment approach aiming at addressing increased pain sensitivity and cervical musculoskeletal impairments, can improve the management of migraine patients. when present will improve migraine management.

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.