Background: A method for assessing dynamic muscle hyperalgesia (dynamic pressure
algometry) has been developed and applied in tension-type and migraine headaches.
Objectives: To investigate differences in dynamic pressure pain assessment over the
trigeminal area between men with cluster headache (CH) and headache-free controls, and the
association between dynamic and static pressure pain sensitivity.
Study Design: A case-control study.
Setting: Tertiary urban hospital.
Methods: Forty men with episodic CH and 40 matched controls participated. Dynamic
pressure pain sensitivity was assessed with a dynamic pressure algometry set consisting of 8
rollers with different fixed levels (500, 700, 850, 1,350, 1,550, 2,200, 3,850, and 5,300 g).
Each roller was moved at a speed of 0.5 cm/sec over a diagonal line covering the temporalis
muscle from an anterior to posterior direction. The dynamic pressure threshold (DPT; load
level of the first painful roller) and the pain intensity perceived at the DPT level (roller-evoked
pain) were assessed. Static pressure pain thresholds (PPT) were also assessed with a digital
pressure algometer applied statically over the mid-muscle belly of the temporalis. Patients
were assessed in a remission phase, at least 3 months from the last cluster attack, and without
preventive medication.
Results: Side-to-side consistency between DPTs (r = 0.781, P < 0.001), roller-evoked pain
on DPT (r = 0.586; P < 0.001), and PPTs (r = 0.874; P < 0.001) were found in men with CH.
DPT was moderately, bilaterally, and side-to-side associated with PPTs (0.663 > r > 0.793, all
P < 0.001). Men with CH had bilateral lower DPT and PPT and reported higher levels of rollerevoked pain (all P < 0.001) than headache-free controls.
Limitations: Only men with episodic CH were included.
Conclusions: This study supports that a dynamic pressure algometry is as valid as a static
pressure algometry for assessing pressure pain sensitivity in patients with CH. Assessing both
dynamic and static pain sensitivity may provide new opportunities for differentiated diagnostics.
Key words: Cluster headache, dynamic pressure pain, pressure pain threshold