The Differential Contribution of Muscle Contraction and Migraine Symptoms to Problem Headache in the General Population


Address Correspondence to: Dr. D. Bakal, Department of Psychology, University of Calgary, Calgary, Alberta T2N 1N4.



The present study examined the prevalence of musculoskeletal, vascular and autonomic symptoms in headache sufferers in the general population. The differential contribution of these different categories of symptoms to varying degrees of problem headache was also examined. The symptoms were assessed by a 14–item questionnaire that permitted the respondents to indicate the extent to which each of the symptoms was perceived to be present across all headache attacks. In addition, a single item was included to assess the extent to which the respondents perceived their headache attacks to be a problem. Questionnaires were obtained from a systematic random sample of 1551 urban-based households. Thirteen of the 14 symptoms showed a positive relationship between the frequency of occurrence and the extent to which headaches were perceived to be a problem. In addition a positive relationship emerged between the number of muscle contraction symptoms reported and the number of migraine symptoms reported. Additional analyses demonstrated that a reversal in symptom dominance occurred across the problem dimension in that musculoskeletal symptoms were more prevalent for headache sufferers who never or seldom perceived their headaches to be a problem while vascular symptoms were more prevalent for headache suffers who often or always perceived their headaches to be a problem. The reversal was only partial however, since the musculoskeletal symptoms of neck pain, back of head pain and feelings of tightness and pressure were found to differentiate the problem headache sufferer from the nonproblem headache sufferer. Overall, the data were viewed as providing additional support for the severity model of headache.