I guess they don't count head-banging....

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Posted by dougW ( on October 04, 2001 at 11:48:32:

as a "pain-relieving manoeuvre". The following article from Cephalgia confirms what most of use know!

Cephalalgia 21 (7), 718-726
International Headache Society

Self-administered pain-relieving manoeuvres in primary headaches
G Zanchin1, F Maggioni1, F Granella2, P Rossi1, L Falco2 and GC Manzoni2

1 Department of Neurology, University of Padua, Padua and 2 Institute of Neurology, University of Parma, Parma, Italy

We investigated the use of self-administered pain-relieving manoeuvres on a sample of 400 patients with primary headaches—represented by an even distribution of migraine without aura (MO), migraine with aura (MA), episodic tension-type headache (TH), and cluster headache (CH)—consecutively seen at Padua and Parma Headache Centres. Manoeuvres on various regions of the head were used by 258 patients (65% of the cases). The most applied procedures were: compression (114 out of 382 manoeuvres; 30%), application of cold (27%), massage (25%) and application of heat (8%). A significant (P < 0.001) relationship was found between headache diagnoses and type of manoeuvre. In MO patients the application of cold (38% of the manoeuvres) and compression (36%), used mainly on the forehead and temples, prevailed; compression, mainly on the temples, was the most frequent procedure (44%) in MA patients. Massage on the temples and nape was the predominant manoeuvre (43%) in TH patients, whereas in the CH group, which more often required heterogeneous procedures, none of the above-mentioned manoeuvres was prevalent. Compression, as a diagnostic criterion for MO, had a sensitivity of 33% and a specificity of 86%; for the application of cold the figures were 36% and 84%, respectively. Massage had a sensitivity of 33% and a specificity of 80% for TH. The efficacy of the self-administered manoeuvres in reducing pain was scarce. Only 8% of the manoeuvres, in fact, resulted in a good or excellent pain control. Moreover, the efficacy of the manoeuvre was often momentary, wearing off when the manoeuvre stopped. In spite of this, 46% of the subjects used the manoeuvres constantly, at each attack.

Self-administered pain-relieving manoeuvres, primary headaches, compression, application of cold or heat, massage


Giorgio Zanchin, Department of Neurology, Via Giustiniani 5, 35128 Padua, Italy. Tel. +39 0498213600, fax +39 0498751770, e-mail zangio@ux1.unipd.it

Received 21 February 2000, accepted 8 March 2001

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