Primary headaches: dysfunctional pains

BACKGROUND AND OBJECTIVES: Headache is a very prevalent symptom, being considered the second more frequent type of pain by international epidemiological studies. It is also an expensive symptom for patients, relatives, society and general health systems, impairing quality of life of those suffering from this problem. Primary headaches, among them migraine and tension headache are classified as dysfunctional headaches. It is important to understand why these two disorders cannot be seen as somatic, neuropathic or visceral pain. This article shall use the terms migraine and megrim as synonyms. This study aimed at defining dysfunctional pain and at justifying why primary headaches are considered dysfunctional pain. CONTENTS: a) Migraine pathophysiology, most prevalent primary headache in medical offices, it is explained as a disease made up of crises which may have up to five phases and not simply as a headache. Migraine crisis phases are: premonitory symptoms, aura, headache, autonomic/hypothalamic symptoms and posdrome. b) Classify migraine as dysfunctional pain because it does not meet criteria to be classified as neuropathic or somatic pain. c) Discuss which type of pain secondary headaches are. CONCLUSION: It is possible to accept the idea that primary headaches are demodulatory pains, but that secondary headaches are nociceptive or visceral.