Myofascial Face Pain Research Articles

Stress-evoked muscle activity in women with and without chronic myofascial face pain.

Amplified muscle activity in reaction to daily life stressors might explain chronic pain in temporomandibular disorder (TMD). To assess whether patients with myofascial TMD pain (MFP) react to standardised stressors with greater masticatory muscle activity than demographically matched controls. A total of 124 female MFP patients and 46 demographically matched and pain-free controls rated distress while performing a series of standardised stress-reactivity tasks (viz., cold pressor test, mental arithmetic test, speech stressor test and reaction time/startle response test) as well as a vanilla baseline control task. Blood pressure was measured before and after each task, and electromyographic (EMG) activity was continuously recorded over the jaw-closing muscles and several non-masticatory muscles during each task. Linear mixed model analyses were used to test the hypothesis that case status, stress-reactivity task and muscle recording site influenced EMG activity. Stress induction was successful, as evidenced by distress ratings and blood pressure measurements that were significantly elevated during performance of the stress tasks. Participants reported that some of the tasks were stressful in a way that resembled stressors experienced in their daily lives. Elevated muscle activity could be confirmed only for the reaction time/startle response task, where mean EMG activity was elevated more in cases than in controls, specifically in the jaw-closing muscles. These data could not provide clear support for the theory that psychological stressors produce a differential increase in masticatory muscle activity in MFP patients than pain-free controls.

Prevalence of myofascial pain in students of selected secondary schools in Baghdad city

Myofascial face pain (MFP) is painful disorder of masticatory muscles thought to be the most common type of temporomandib ular disorder (TMD).This study was done to evaluate the prevalence of MFP in students of secondary schools of Baghdad city Materials and methods: The sample comprised 242 females' students and 222 males' students of secondary schools, aged 17-18 years. The MFP evaluated according to the specific screening questionnaire of research diagnostic criteria of temporomandibular disorders (RDC/TMD) axis I with clinical examination. Results: the study revealed that (50.8%) of the students had history of pain where females reported higher percentage than males with statistical significant difference. The history of pain in muscles of mastication was higher than joint pain in both genders. After clinical examination this study also showed that (25.4%) of students with history of pain had MFP. The differences between both genders regarding the diagnosis of MFP were higher in females than males but statistically not significant. Conclusion: high percentage of students reported a history of pain which could be attributed to MFP in (25.4%) of the students. The prevalence of pain history and MFP was higher in females' than males.

Complex approach in the treatment and rehabilitation of the patients with myofascial face pain syndrome

Determination the tactics of the treatment and rehabilitation of the patients with myofascial face pain syndrome (MFFPS). The complex of clinical and radiologic diagnostic methods to 83 patients with myofascial face pain syndrome and mandible movement disorder have performed. Patient examination have made it possible for to define succession and efforts, to reduce pain syndrome intensity, to normalize mandible movements. MFFPS treatment requires the participation of stomatologist, neurologist, roentgenologist, psychologist, therapeutist.

The Role of Tooth-Grinding in the Maintenance of Myofascial Face Pain: A Test of Alternate Models

While mechanisms of myofascial face pain are poorly understood, bruxism has been implicated in the maintenance of this painful disorder. This study evaluates whether evidence of one aspect of bruxism, tooth-grinding, is positively associated with pain severity, as predicted by a psychophysiological model, or negatively associated, as predicted by an adaptation model of face pain. Participants were 51 women who met Research Diagnostic Criteria for the myofascial subtype of temporomandibular disorder. Tooth-grinding was quantified by changes in microwear features of the molar teeth over 2 weeks. Palpated pain severity was quantified on an 11-point scale in response to palpation of the skin overlying the masseter and temporalis muscles bilaterally. Other measures included validated scales of spontaneous pain severity, stress, distress, and psychological symptoms. Association was quantified as Pearson correlation coefficients. Data showed an inverse correlation (r = -0.37, P < 0.05) between palpated pain severity and the index of tooth wear, supporting the adaptation model. This correlation provided a weighted average of a strong effect (r = -0.80, P < 0.01) seen in those women reporting pain only the right side of their face with an effect that approximated zero in those reporting bilateral pain. Tooth wear measures were negatively associated with ratings of pain severity only over the right masseter. While these data do not address the role of clenching, they cast serious doubt on the theory that myofascial face pain is maintained by tooth-grinding.

Prevalence of myofascial face pain in the community and its comorbidity with fibromyalgia

Prevalence of myofascial face pain in the community and its comorbidity with fibromyalgia

Widespread pain and the effectiveness of oral splints in myofascial face pain

The research literature reaches inconsistent conclusions about the efficacy of oral splints for treating myofascial face pain. This investigation hypothesizes that their effectiveness varies as a function of the presence or absence of widespread pain. In a randomized, controlled clinical trial, 63 women with myofascial face pain were assigned to use of either an active, maxillary, flat-plane, hard acrylic splint or a palatal splint that did not interfere with occlusion. Participants also were classified according to the presence or absence of widespread pain throughout the body. After six weeks, groups were compared regarding pain on palpation, self-reported pain and functional outcome. Overall, the findings showed a modest tendency for subjects receiving the active vs. the palatal splint to exhibit improvement on self-reported pain and functional outcome. On further division of the sample into subjects with local vs. widespread pain, the general pattern showed that patients with widespread pain who received an active splint did not experience improvement, while patients with local pain who received the active splint did. The presence or absence of widespread pain may help to define the specific circumstances under which oral splints should be prescribed for patients with myofascial face pain. Clinicians should screen patients with myofascial face pain for the presence of widespread pain, since this comorbid symptom pattern may be a contraindication for the use of oral splints.

Somatosensory amplification and affective inhibition are elevated in myofascial face pain.

This study was designed to determine whether affective inhibition and somatosensory amplification are elevated in patients with a history of myofascial face pain (MFP). These processes may underlie a tendency to express distress in somatic rather than affective terms, leading to somatized or masked depression. Women (n = 162) with a history of MFP were compared with demographically equivalent women (n = 173) without MFP histories on self-report scales of affective inhibition and somatosensory amplification. Structured psychiatric interviews and health histories were conducted. In addition, a first-degree relative of 106 myofascial face pain subjects and 118 control subjects completed these same self-report scales. MFP cases and controls differed significantly on measures of affective inhibition and somatosensory amplification. History of depression or current psychological distress did not account for group differences. Elevated levels of somatosensory amplification were confined to MFP women with active symptoms. Finally, although both somatosensory amplification and affective inhibition showed a tendency to run in families, familial transmission did not account for case/control differences. Affective inhibition and somatosensory amplification are likely to be elevated in patients with MFP. Although not accounted for by psychiatric symptomatology, the possibility that these response styles are reactive to coping with chronic face pain cannot be ruled out.

MYOFASCIAL FACE PAIN: Clinical Characteristics of Those With Regional vs. Widespread Pain

The authors conducted a study to determine whether there are differences in salient clinical characteristics between patients who have both myofascial face pain, or MFP, and comorbid fibromyalgia, or FM, and patients who have MFP but not FM. The authors enrolled in the study 162 female subjects who had histories of MFP. In physical examinations at the time of initial consultation, they recorded facial pain signs and symptoms. At the research interview follow-up (seven years post-consultation), participants were screened for a lifetime history of FM and other health problems. In addition, psychiatric interviewers conducted the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Third Edition-Revised, to assess each patient's history of depression and other psychiatric disorders. Of the 162 participants, 38 (23.5 percent) reported a history of FM. At the time of treatment for MFP, both the FM and non-FM groups had similar signs and symptoms of MFP. At the time of the research interview follow-up, participants with FM histories were significantly less likely than those without FM histories to report that they were free of MFP. On recall, those with FM histories reported experiencing more symptoms of MFP. Those with FM histories also were more likely to have had major depression and to report somatization symptoms. Finally, those who had FM more commonly had a history of facial pain's interference with social and occupational functioning and had more severe pain than did those without FM. Patients who have MFP and a history of widespread pain suggestive of FM are likely to have more persistent and debilitating MFP and to have higher rates of depression and somatization symptoms than those who have no history of widespread pain.

Why is depression comorbid with chronic myofascial face pain?: A family study test of alternative hypotheses

A number of explanations have been proposed to account for findings that rates of depression are elevated in persons with chronic, non-malignant pain disorders (CNPDs); for example, that CNPDs are variants of depression (e.g. ‘masked depression’), that the stress of living with CNPDs contribute to the onset of depression (‘diathesis-stress’), or that the correlation of CNPDs and depression is a methodological artifact of studying treatment-seeking samples. These alternative hypotheses are tested for one specific CNPD, chronic myofascial face pain, using a family study methodology. The procedure was to conduct direct psychiatric interviews with 106 patients with a history of carefully diagnosed myofascial face pain, 118 acquaintance controls without personal histories of myofascial face pain, and a random sample of adult first degree relatives of these case and control probands. The probands were further subdivided into four roughly equal samples consisting of cases with and without personal histories of major depressive disorder (MDD), and controls with and without personal histories of MDD. Dates of initial onsets of myofascial face pain and MDD in patient probands were obtained from interviews and records. The main results were that, compared to control probands without personal histories of MDD, MDD and depressive spectrum disorders (DSD) were elevated in the first degree relatives of control probands with personal histories of early onset MDD, but not in the first degree relatives of myofascial face pain probands with or without personal histories of early or late onset MDD. This outcome is consistent with the hypothesis that living with chronic myofascial face pain contributes to elevated rates of depression. It is inconsistent with the alternative hypotheses that this CNPD is a variant of depression or that the elevated MDD rates are simply an artifact of selection into treatment. The implications of these results and additional results consistent with them are discussed.

Myofascial face pain: seasonal variability in pain intensity and demoralization

Seasonal variability has been detected in a variety of illnesses. The purpose of this study is to examine seasonal variability in pain intensity, demoralization and range of mandibular motion among patients suffering from myofascial face pain. Pain and demoralization for cases (n = 140) and demoralization for controls (n = 133) were measured in each of 10 monthly interviews. Range of motion was measured once only for cases. Their pain intensity ( P < 0.009) and demoralization ( P < 0.04) were significantly greater in the peak dark months than in the peak light months. There was a non-significant trend ( P < 0.07) toward elevated demoralization in the darker months for controls. Range of motion, assessed cross-sectionally, did not demonstrate a seasonal pattern. These data support our prior finding that myofascial face pain and depressed mood are co-morbid and may be maintained by common risk factors.

The examination of myofascial face pain and its relationship to psychological distress among women.

In this study, 110 female myofascial face pain patients were assessed monthly for 10 months on measures of pain, distress, and stressful life events. D. A. Kenny and A. J. Zautra's (1995) structural equation model for examining the separate trait, state, and error components of the variables was used to analyze the data. Both pain and distress had sizable trait variance, and the trait components were correlated. The 2 variables also showed sizable state variance, and the states of pain covaried with states of distress. A significant time-lagged relationship between the 2 variables was found: Increases in distress led to elevations in pain 1 month later. Stressful life events arising from major social roles were also associated with greater distress, but not pain. Illness events unrelated to the pain syndrome were associated with both pain and distress.

The examination of myofascial face pain and its relationship to psychological distress among women.

In this study, 110 female myofascial face pain patients were assessed monthly for 10 months on measures of pain, distress, and stressful life events. D. A. Kenny and A. J. Zautra's (1995) structural equation model for examining the separate trait, state, and error components of the variables was used to analyze the data. Both pain and distress had sizable trait variance, and the trait components were correlated. The 2 variables also showed sizable state variance, and the states of pain covaried with states of distress. A significant time-lagged relationship between the 2 variables was found: Increases in distress led to elevations in pain 1 month later. Stressful life events arising from major social roles were also associated with greater distress, but not pain. Illness events unrelated to the pain syndrome were associated with both pain and distress.