Can those with migraine have a fluctuating threshold of pain between and during attacks?
Although the pain threshold of those with migraine is usually lower than normal during an attack, levels can fluctuate throughout the migraine cycle and between attacks.
“People with migraine have lower thresholds, so it takes less stimulus to cause pain. That's going to be most prominent during a migraine attack, but it does persist even between attacks. It may actually fluctuate in a way where, as a person with migraine gets closer to having their next migraine episode, that their thresholds drop, so in the pre-attack phase, they might have a lower pain threshold than they do when they're truly in between episodes.”
It is important to note the difference between pain threshold and pain tolerance. Pain threshold is the point at which pain is felt and pain tolerance is how much pain a person can tolerate.
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Todd Schwedt, MD
Professor of Neurology
Mayo Clinic School of Medicine in Arizona
As a Professor of Neurology the Mayo Clinic School of Medicine in Arizona, Dr. Todd Schwedt has seen thousands of migraine patients and evaluated a large number of scans of our hypersensitive brains. His research using advanced MRI techniques has been widely published. He serves on the Board of Directors of the American Headache Society, is the Vice Chairman of the Headache and Facial Pain section of the American Academy of Neurology, is a member of the International Headache Society Classification Committee, and is an Associate editor of Headache, Cephalalgia and Pain Medicine journals.