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I found the following sentence

たとえばさえりさんの頭が10ヶ月ずっと痛かったとしたら、それが通常になると思いますか？

From this article: http://liginc.co.jp/241030

Why does he opt to use ずっと痛かったとしたら rather than simply ずっと痛かったら ?

What is the nuance being communicated in cases like these?

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The difference is fairly subtle, but it is there.

The nuance is that using 「としたら」 helps the speaker emphasize the fact that it is a hypothetical discussion that he is engaged in at the moment.

I must add, though, that the difference that 「としたら」 creates is not all that substantial because 「ずっと[痛]{いた}かったら」 is already hypothetical without using 「としたら」.

I think that the difference is like one between:

"If the pain were to continue" and "If the pain continued".

The former would have the feeling of 「～～としたら」.

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