Regional and Extraregional Pressure Pain Threshold Patterns in Tension-Type Headache and Low Back Pain: A Cross-Sectional Comparative Study

Background/Objectives: Tension-type headache (TTH) and low back pain (LBP) are common chronic pain disorders associated with altered mechanical pain sensitivity, but direct comparison of regional pressure pain threshold (PPT) patterns remains limited. Methods: This cross-sectional comparative study included 600 participants: 200 patients with TTH, 200 patients with LBP, and 200 healthy controls. PPT was assessed using digital pressure algometry in cranial, lumbar, and lower-extremity regions. Each point was tested three times, and mean regional values were calculated. Between-group differences were analyzed using one-way ANOVA. ANCOVA models were additionally adjusted for age, sex, and BMI, and patient-only multivariable regression models were adjusted for age, sex, BMI, pain intensity, and symptom duration. Results: Significant differences were observed in all examined regions (all p < 0.001). Patients with TTH had the lowest cranial PPT values, whereas patients with LBP showed the lowest lumbar PPT values. Both pain groups also demonstrated significantly reduced PPT values in anatomically distant regions compared with healthy controls. These regional differences remained significant after adjustment for relevant demographic, anthropometric, and clinical variables. Conclusions: TTH and LBP demonstrate distinct regional PPT profiles while sharing a pattern of extraregional mechanical hypersensitivity. These findings may be compatible with broader alterations in nociceptive processing, although central sensitization was not directly assessed.