Results from a new opinion poll are now published in the Migraine Impact Report. The answers to some poll questions might surprise you. Read on!

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Clinicians who manage migraine pain know that its effect on individuals is frequently underestimated. But to say it is on par with or worse than childbirth, kidney stones, or broken bones may seem like a tremendous stretch to many. But that is exactly what a new Nielsen opinion poll called the Migraine Impact Report shows. In the survey, among patients who had experienced both types of pain, their worst migraine pain ranked higher than that of childbirth with an average score of 8.6, on a 10-point scale (with 10 being most severe) for migraine compared to 7.3 for childbirth. Kidney stones rated at 8.3 and broken bones came in at a score of 7.0. I have treated thousands of patients over the years with acute migraine so bad they couldn’t even move without aggravating the severe pain, the waves of persistent nausea and vomiting, the pounding in the head with every heartbeat, and the extreme light and noise sensitivity. No question about it, this is serious pain. But I have also witnessed dozens of live births in my life (four of them my own kids). And the pain that mothers go through to bring new life into the world is incredible. As a man, I know I will never be able to fathom it. I have also seen and experienced kidney stones and broken bones. The pain with those situations is horrific and can seem unbearable in the moment. So how can we explain the way the survey results turned out?

First of all, this is not a scientific survey. It is merely an opinion poll. It doesn’t mean the answers are meaningless. It’s just that we are comparing apples to oranges here. Migraine is a chronic recurring pain disorder. Childbirth, kidney stones, and broken bones are isolated, infrequent events (at least for most of us!). To compare the chronic pain experience to a self-limited painful event is not a legitimate comparison. For one thing, chronic pain has a cumulative effect on the brain’s ability to deal with pain over time. People find ways to cope or push through it, but the chronic or recurrent pain experience actually tends to get worse over time if inadequately treated. Furthermore, the depressed moods and anxiety that come from chronic pain tend to amplify the pain experience. They also affect how patients respond to questions about it. These changes don’t typically occur in transient painful conditions, even if they are severe. And at least in the case of childbirth, even though it is immensely painful, there can be significantly positive aspects to the experience which makes the pain less memorable. So when you think about it, maybe we can find ways to understand the way patients responded to the survey after all. Rather than parse words over how to describe pain and compare painful events, I think it makes the most sense to understand that the survey is merely identifying the difference between acute, self-limited pain events and chronic relapsing and remitting pain disorders. And above all, it points out that migraine is not a trivial illness. It is potentially incapacitating and is definitely to be taken very seriously.

A couple of other quick points from the survey: 55% of adult migraine sufferers feel that migraine has impacted their career goals. 72% indicated that migraine affects their ability to take care of their family. And 81% wish they had better treatment or ways to manage their migraine attacks. For those folks, there is good news. Medical research is bringing new treatments to the market which could be life changing for many. And they could start becoming available as soon as this summer! These new treatments interfere with a chemical in the brain called CGRP, which is one of the main contributors to the symptoms of migraine. With these new CGRP blockers and other medicines in the research pipeline, I think in 5 to 10 years, the way we think about and treat migraine will be completely different from that of today. I promise to keep you up to date on new developments. So keep following StudyMetrix Research and the National Headache Foundation to stay on top of the latest trends.

In the meantime, I’m curious as to what you think about today’s topic. How do you rank migraine against other pain you have experienced? Is it close? Which is worse? And what about comparing migraine to other chronic or recurrent pain disorders? Would love to hear about your own experiences!

Until next time, stay well! And be sure to support research in your community, wherever you are!

Timothy R Smith, MD, RPh

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