Results of upper cervical palpation test in migraine patients are not explained by pain sensitization

The exact cause for no pain, local pain and referred pain groups according to the upper cervical palpation test (UPT) and whether neck pain in migraine patients is caused due to pain sensitization or influenced by perceived neck-related disability, is not fully understood. The aim was to determine whether upper cervical spine sensitivity tested by the UPT is associated with neck-related disability or increased pain sensitization in patients with migraine. Forty-two patients with episodic migraine were examined regarding mechanical and pressure pain thresholds, central sensitization (CSI), allodynia (ASC-12) and neck-related disability (NDI), and sub-grouped according to the UPT. An ANOVA analysis was performed for group differences. Exploratory regression and correlation analyses were performed with NDI and CSI as dependent variables to understand which factors are related and contribute to either subgroup allocation. No significant differences were found in UPT subgroups regarding CSI and NDI. The UPT subgroups could not be determined by any evaluated variable. The NDI was explained in 43.6% by the CSI and neck pain intensity. CSI results were explained to 49.4% by a model including ASC-12 and NDI. In conclusion, UPT subgroups were neither explained by differences in CSI, mechanical or pressure threshold testing or NDI.