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Limb Pain May Be Part of the Migraine Spectrum

Science has revealed a familial form of limb pain and migraine. A recent four-generation study suggests that limb pain may be an unrecognized manifestation of migraine headaches.

Researchers studied a 27-member family for 8 years and found an autosomal dominant inheritance pattern involving arm or leg pain during a migraine episode, cluster headache, or cluster migraine.

Doctors say 8 of the 27 members of the family had benign recurrent limb and/or body pain. Pain began as early as age 8 years and as late as age 30, and it recurred over 5 to 52 years. Sites of pain were the arm, hand, shoulder, chest, and neck. Limb pain was unilateral but could vary sides from episode to episode. Headache (7 of 8 members with some form of aura) occurred before, during, or after limb pain, and limb pain in adults could occur without headache.

What is interesting is that scientists found manifestations of the condition changed over time. Children frequently had limb pain without headache. As the children aged, the limb pain subsided, but migraine headache developed.

Doctors suggest that recognition of limb pain in migraine is important for preventing unnecessary investigations and getting people on appropriate treatments. For example, migraine-triggered limb pain may be mistaken for nerve entrapment, radiculopathy, thoracic outlet syndrome, chronic fatigue syndrome, functional symptoms, or arthritis. In children, possible reasons include growing pains, and bone or joint pathology.

The good news: The syndrome responds well to acute migraine treatment.  As with any form of therapy, a good medical history can lead to very effective pain management and treatment, as well as avoiding unnecessary testing, referrals, misdiagnosis, delayed diagnosis, and suffering.