According to a recently published observational study in the Journal of Headache and Pain, exclusion of changes in avoidance or endurance behaviour is associated with improved headache frequency and functional ability. Avoidance and endurance behaviour affects chronic musculoskeletal pain significantly, but its impact on migraine was still not clear. A total of 128 migraineurs were assessed for Migraine Disability Assessment Scale (MIDAS), Avoidance-Endurance Questionnaire behavioural subscales, Hospital Anxiety and Depression Scale (HADS), and Pain Disability Index (PDI). Sixty-nine out of 128 participants were re-evaluated after 3–6 months.

There was a positive association between pain-related disability and avoidance, particularly the social avoidance behaviour at the baseline. The negative association between PDI scores and endurance behaviour was not able to sustain multiple regression analysis. Besides, HADS anxiety score and endurance exhibited a negative relation, and HADS depression score and social avoidance showed a positive relationship. Avoidance and endurance exhibited no association with the diagnosis of episodic vs chronic migraine, headache frequency and intensity. Following the 3 to 6 months post-treatment, a significant improvement was noticed in headache intensity, frequency, and pain-related disability; whereas avoidance and endurance remained were consistent.

These findings explain that unaltered avoidance or endurance behaviour shows improvement in headache frequency and pain-related disability.