Chronic Pain Research Articles

Exploring the Needs of People With Chronic Low Back Pain and Health Care Professionals for mHealth Devices to Support Self-Managed Physical Activity and Pain: User-Centered Design Approach

Background Chronic low back pain (CLBP) is a major economic and social problem worldwide. Despite the variety of recommended treatments, long-term self-management of this condition is complex and requires the development of innovative interventions. Mobile health (mHealth) technologies hold great promise for the management of chronic pain, particularly to support physical activity. However, their implementation is challenged by a lack of user compliance and limited engagement, which may be due to insufficient consideration of the needs of potential users during development. Objective This study aims to explore the needs of people with CLBP and health care professionals regarding mHealth technologies to support self-managed physical activity, and to delineate design recommendations based on identified needs. Methods A participatory study was conducted using a 3-phase, user-centered design approach: needs investigation with a group of experts in a workshop (phase 1), needs exploration with end users in focus groups (phase 2), and validation of needs using Delphi questionnaires followed by the development of a set of recommendations (phase 3). Results A total of 121 people with CLBP, expert patients, health care professionals, rehabilitation researchers, and biomechanical engineers participated in this study. The results indicated how technology could help people with CLBP overcome their difficulties with managing physical activity. Specific needs were formulated concerning device objectives, expected strategies, functionalities, technical features, conditions of use, and potential facilitators and barriers to use. These needs were validated by consensus from the potential end users and translated into design recommendations. Conclusions This study provides design recommendations for the development of an mHealth device specifically adapted for people with CLBP.

Expanding Naloxone Coprescribing at a Regional VA Medical Center.

Veterans are disproportionately affected by chronic pain and are more likely to be prescribed opioids. As a means of risk mitigation, the Centers for Disease Control and Prevention and Department of Defense recommend naloxone for patients on opioids with risk factors, including use of ≥50 morphine milligram equivalents daily, concurrent benzodiazepine/sedative use, and pulmonary or liver disease. An interprofessional quality improvement team consisting of 6 residents, a pharmacist, a nurse educator, and a faculty mentor was formed to increase naloxone coprescriptions at a regional VA medical center Continuity of Care Clinic. Primary intervention identified eligible patients via the VA Primary Care Almanac's Opioid Therapy Risk Report and alerted providers by email and secure messaging. Naloxone coprescription rates increased from 42% initially in June 2022 to 82% by June 2023 (29/69 to 41/50 patients, P < 0.0001). This project demonstrates that notifying providers of high-risk patients can significantly increase naloxone coprescriptions.

OUTCOME MEASURES FOR CERVICOGENIC DIZZINESS: A META ANALYSIS.

Background: Cervicogenic dizziness (CGD) is a complex condition characterized by dizziness arising from cervical spine disorders. It affects approximately 40% of patients with chronic neck pain and can significantly impact daily activities, quality of life, and mental health. The involvement of cervical structure in vestibular function highlights the need for effective assessment tools. Outcome measures play a crucial role in diagnosing CGD, evaluating treatment effectiveness, and improving patient outcomes. This evolved, focusing on both subjective and objective assessments, including symptom questionnaires, functional scales, and vestibular function tests. Standardized outcome measures are essential for clinical making and guideline development. Objective: The objective of the study is to systematically evaluate and compare the reliability, validity and sensitivity data of various outcome measures of cervicogenic dizziness. Method: The systemic data were searched using PubMed, Scopus, Google scholar, Science direct, PEDro, Cochrane library to identify studies published from the year 2001 up to 2023. Study selection is reported according to PRISMA guidelines. A total of 50 review articles were collected on outcome measures for Cervicogenic Dizziness (CGD). Data extraction included Research, Evidence based study, Literature, Systematic reviews and Meta-analysis articles. Result: This meta-analysis states that outcomes measures for Cervicogenic Dizziness (CGD) show a highly significant difference. Conclusion: After analysis of various articles, it was concluded that diagnosing patients with outcome measures for Cervicogenic Dizziness shows highly significant and improving health care efficiency. This study identified reliable and valid outcome measures for assessing Cervicogenic Dizziness (CGD). Implication: This study findings have significant implication for clinical practice, research, and policy, enhancing diagnosis, treatment and patient outcomes, standardized use of validated outcome measures will inform evidence – based guidelines for Cervicogenic Dizziness.

Combat-Relevant Anesthesia Fellowships Help Sustain the Army’s Multidomain Medical Force

ABSTRACT In the community of Army Nurse Anesthetists, there is an underutilized potential for Combat-Relevant Fellowship training that, if enthusiastically encouraged and taken advantage of, would proffer many benefits to the Military Health System and the beneficiaries of its care. Most importantly, increased access to and encouragement for participation in these fellowships for Nurse Anesthetists would act as a tool for skill sustainment, denying any potential for skill degradation or readiness gaps in preparation for the next-generation war. These fellowships would also augment the already robust breadth, quality, and safety of Army Nurse Anesthetists’ combat and noncombat anesthesia care, potentially increase Return-To-Duty rates, potentially expedite casualty clearance of the battlefield, increase the often-limited access to advanced pain management care for chronic pain patients in Military Treatment Facilities, increase the retention rates of Nurse Anesthetists, augment the military anesthesia community’s knowledge-base, and help to advance the art of anesthesia as a whole. To triumph against the anticipated rigors of the future war’s multidomain operational environment, we are duty bound to continually improve and strive to be the best versions of ourselves as soldiers, as professionals, and as communities. This paper will explore the untapped utility of Combat-Relevant Fellowships for Army Nurse Anesthetists.

INFLUENCE OF POPLITEUS MUSCLE MANIPULATION AND QUADRICEPS STRENGTHENING ON ANTERIOR KNEE PAIN IN RUNNERS

Background: Anterior knee pain is prevalent among young athletes, with sports-related injuries accounting for 25–30% of cases. Patellofemoral pain syndrome (PFPS) contributes to up to 40% of knee disorders, with annual prevalence rates reported at 22.7% in the general population and 28.9% in adolescents. Among runners, the incidence of PFPS ranges from 37% to 56%. Objective: The popliteus muscle is primarily associated with anterior knee pain but may also influence posterior knee discomfort. This study aims to investigate the effects of soft tissue manipulation of the popliteus muscle combined with quadriceps strengthening exercises on anterior knee pain in athletic runners, addressing a gap in the literature regarding the interaction between these muscle groups. Methods: In this experimental study, 30 subjects with non-traumatic anterior knee pain were recruited. Baseline assessments included quadriceps strength and pain levels. Participants then underwent six sessions of popliteus manipulation alongside quadriceps strengthening exercises. Post-intervention, all parameters were reassessed. Results: A significant reduction in knee pain (P &lt; 0.005) was observed after the six-week intervention, with more pronounced improvements in Group A compared to Group B. Conclusion: The results suggest that incorporating popliteus soft tissue manipulation can effectively reduce anterior knee pain while strengthening the quadriceps enhances muscle function. These findings support the integration of popliteus manipulation into treatment protocols for athletes experiencing anterior knee pain.

Chronic pain among primary fentanyl users: The concept of self-medication.

Chronic pain is among the leading causes of disability worldwide, of which only a small percentage of patients receive adequate treatment for. Non-prescribed opioid analgesics are commonly sought out in effort to alleviate unrelieved pain. This study assesses the prevalence and correlates of chronic pain among primary fentanyl users. A cross-sectional and structured survey was conducted with 200 adults who reported fentanyl as their drug of choice from a Vancouver acute care hospital. Presence and levels of chronic pain were determined through self-report. The majority of participants (n = 130, 72.6%) reported having chronic pain in the past 6 months, with the mean level of pain on a typical day to be 7.6 out of a scale of 10 (SD = 1.9). Majority (n = 85, 65.4%) reported using street opioids to self-medicate, while only 9 (6.9%) reported that their chronic pain was unrelated. Regression analysis indicated that increasing age and co-use of cannabis and opioids were independent associated factors of chronic pain. Higher levels of reported pain on a typical day were further associated with age and self-medication. The findings of this study demonstrate a significant association between self-medication and chronic pain among primary fentanyl users in British Columbia. For these individuals, inadequate pain relief may drive continued opioid use, which in turn may increase risks of treatment discontinuation and overdose. Appropriate pain management strategies are crucial to avoid opioid misuse and decrease the large societal burden caused by chronic pain. Our work points to the high prevalence of self-reported chronic pain among individuals who primarily use fentanyl. Among those with self-reported fentanyl use and chronic pain, self-medication with street opioids was found to be common and associated with higher reported pain levels on a typical day. This highlights the need for pain management strategies to be integrated into opioid dependence treatment and more research in the overlap of pain and fentanyl use.

Chronic pain in older adults with disabilities is associated with cognitive impairment-a prospective cohort study.

Chronic pain may be an important factor influencing cognitive impairment; however, there is limited research on that link in older adults with disabilities. We aimed to determine the association between chronic pain and cognitive impairment in older adults with disabilities. This 24-month prospective cohort study involved 143 Japanese older adults (≥65 years of age) with long-term care insurance. Chronic pain was defined as pain persisting for ≥3 months, and cognitive impairment was defined as a Mini-Mental State Examination score ≤ 23. We employed logistic regression analysis with chronic pain as the independent variable and cognitive impairment as the dependent variable after propensity score matching (PSM). Sixty-six participants were selected using PSM, and logistic regression analysis showed that chronic pain was significantly associated with cognitive impairment (odds ratio: 4.103, 95% confidence interval: 1.455-11.567, P = 0.008). To prevent cognitive impairment in older adults with disabilities, the management of chronic pain should be considered, as they are related.

"Pushed to Their Limits": Health Care Provider Perspectives on Barriers and Facilitators to Implementing a Mind-Body and Activity Program for Older Adults With Chronic Pain in a Community Clinic for the Underserved.

Older adults from underserved backgrounds experience chronic pain at a rate of 60% to 75%. Pharmacological treatments have limited efficacy and involve considerable risks. Mind-body interventions hold promise to improve pain outcomes but are typically not implemented in community clinics in which they are needed most, thus contributing to health disparities in chronic pain treatment. We conducted qualitative focus groups and interviews with 20 providers (eg, primary care doctors, nurses, administrators). We sought their perspectives on barriers and facilitators to implementing an evidence based mind-body activity program for older adults with chronic pain at an underserved community health clinic in Massachusetts. Subthemes were identified within 2 superordinate domains (barriers and facilitators) using a hybrid inductive-deductive thematic analysis approach following the Framework Method. Providers discussed facilitators (partner with clinic staff to facilitate referrals and buy-in, integrate referrals through the electronic medical record, offer groups in different languages, post and tailor advertisements) and barriers (limited staff bandwidth, scheduling challenges, inconsistent patient participation). These results will directly inform tailoring and subsequent effectiveness testing and implementation of the pain management program for older underserved adults with chronic pain in this community health care setting.

The impact of co-occurring chronic pain and mental health symptoms on adolescent functioning, a cross-sectional survey.

Adolescents who experience poor mental health may develop chronic pain. Similarly, those with chronic pain may develop mental health symptoms. Little is known concerning how these co-occurring symptoms are associated with adolescent functioning. Our online cross-sectional quantitative study compared the specific nature of challenges to psychosocial functioning, across 4 groups: (1) adolescents with co-occurring chronic pain and mental health symptoms; (2) adolescents who only experience chronic pain symptoms; (3) adolescents who only experience mental health symptoms, and (4) adolescents who do not report either symptom. Participants completed self-report questionnaires assessing pain experiences, mental health symptoms and psychosocial functioning. After controlling for pain intensity, findings revealed significant differences, in physical, social, and family functioning across all groups. Significantly worse physical functioning was reported by adolescents with co-occurring pain and mental health symptoms and those with pain-only symptoms compared with adolescents with mental health-only symptoms and those without symptoms. Social functioning was significantly worse for adolescents who experienced co-occurring chronic pain and mental health symptoms compared with adolescents who experienced pain-only symptoms, and those with no symptoms. Significantly worse family functioning was reported by adolescents with mental health-only symptoms compared with adolescents reporting pain-only symptoms and no symptoms. Results suggest the combined impact of pain and mental health symptoms mainly influences adolescent social functioning. Future research is needed to develop standardised assessment and treatment plans to facilitate a thorough understanding of symptoms presented by adolescents who experience co-occurring pain and mental health symptoms.This study identifies that the combined impact of pain and mental health symptoms influences adolescent social functioning when compared to adolescents who experience pain-only or those without symptoms. Research is needed to develop standardised assessment and treatment plans to fully understand the symptoms presented by adolescents with co-occurring symptoms.

The comparison of Pilates with cognitive functional therapy in adults with chronic neck pain: a protocol for randomized controlled trial

Background Chronic Neck Pain is one of the main musculoskeletal problems in the general population that negatively affects the lives of patients. Its treatment can include various treatment methods, such as Pilates and Cognitive Functional Therapy. The purpose of this research was to investigate the effectiveness of Pilates in relation to Cognitive Functional Therapy in people with Chronic Neck Pain. Methods This single-blind randomized controlled study included 60 patients with Chronic Neck Pain who were randomly divided into two groups (Group 1: Pilates, Group 2: Cognitive Functional Therapy). All patients will undergo 16 sessions over 8 weeks. Outcome measures (pain, disability, fear perception, functionality, quality of life, cervical range of motion, and neck muscle isometric strength) will be evaluated at baseline, at the end of the treatment (week 8) and three months after randomization (week 12). Outcome measures will be analyzed via random effects at the three assessment time points, and the interactions of the treatment groups with the assessment points will be included in the results of the fixed model. Discussion This is the first Randomized Controlled Trial to compare the effectiveness of Pilates and Cognitive Functional Therapy in patients with chronic neck pain. The results of this research will provide information on the effectiveness of each intervention separately and whether one of the two can outperform the other.

Valproate-induced hyperammonemic encephalopathy in neurosurgical patients: Our experience and systematic literature review.

Sodium valproate is used for the management of seizures, status epilepticus, chronic pain syndrome, bipolar, and other affective disorders. Even with an acceptable safety profile, severe idiosyncratic reactions can occur with valproate use. A rare, serious, and life-threatening side effect of valproate is valproate-induced hyperammonemic encephalopathy (VHE). We intend to analyze the clinical presentation, diagnosis, treatment options, and outcome of VHE in neurosurgical patients and review the pertinent literature on this rare sequelae. We retrospectively reviewed patients who developed VHE following valproate use, either for the treatment of epilepsy or for seizure prophylaxis in our centre. We analyzed the demographic details, clinical presentation, diagnosis, management, and outcomes. A total of four patients with a mean age of 26.3 ± 5.1 (range 19 - 32years). Valproate was prescribed for primary seizure prophylaxis in 2 patients (50%). The commonest etiology for valproate prescription was for brain tumors (3, 75%) followed by drug-refractory epilepsy (DRE) (1, 25%). None of the patients were documented to have urea cycle disorder. The mean daily prescribed dosage of valproate was 1250 ± 559mg and the mean duration of administration was 13 ± 13.3months (range 4months - 36months). The mean serum NH3 level was 136,5 ± 44.2µmol/L (range 107 - 212.8) and all patients (4, 100%) had hyperammonemia with a mortality rate of 50% (2 patients). The hyperammonemia was treated by stopping the valproate use (4, 100%) and dialysis (2, 50%). Normalization of ammonia levels led to clinical improvement in 50% (2 patients). Neurological deterioration in the postoperative period is a diagnostic challenge. VHE is a rare and life-threatening sequelae of Valproate-associated Hyperammonemia (VAH) in neurosurgical patients. A high index of suspicion is required due to its ambiguous presentation. Early diagnosis and prompt treatment can change the course of this life-threatening sequelae.

Effectiveness of dry needle therapy in patients with chronic nonspecific low back pain

Background: Low back pain is a prevalent symptom worldwide, with various underlying causes, making differential diagnosis essential. This study aims to investigate the efficacy of dry needling treatment added to exercise in patients with chronic Nonspecific Low Back Pain (NLBP). The McKenzie exercise program was applied to all participants.Materials and Method: The study comprised sixty participants, randomly allocated into two groups: the dry needling (DNG) and the exercise group (EG). The participants in DNG received a total of six sessions of dry needling treatment, two days a week, to the gluteus medius and quadratus lumborum and multifidus muscles. All participants were given a McKenzie exercise program two sets per day for three weeks.Results: A significant difference was noted in the VAS-night values of the patients within the DNG before treatment (p: 0.004), and the EG also exhibited a significant difference in the VAS-activity (p: 0.017) and VAS-resting (p: 0.024) values following the treatment. A statistically significant decrease was observed in favor of DNG in VAS-rest, VAS-night, VAS-activity values (p&gt;0.001) in the comparions of the groups.Conclusions: Dry needling treatment added to exercise therapy in chronic NLBP patients is effective on activity and rest pain severity in the shortterm results. However, no additive efficacy of dry needling treatment was found on the number of trigger points, disability, and depression.

Unintentionally Retained Elevator Blade Left for 8 Years Causes Mild Chronic Pain.

Fracture of surgical instruments in dental practice is not usually reported in the literature. Management involves searching for and retrieving the fragment to avoid issues such as infection, swallowing, or aspiration. Although foreign bodies may not cause symptoms for years, some can cause chronic pain. The authors describe herein the unusual case of an unintentionally retained broken elevator blade left for 8 years before being found during an orthodontic evaluation. Panoramic radiography revealed a foreign body in the alveolar bone of the right mandibular third molar that was causing mild chronic pain. The patient was unaware whether routine radiographic examination had revealed its presence. Cone-beam computer tomography was performed to identify the position of the blade fragment, and surgery was performed to retrieve it. The mild chronic pain disappeared after removal. It is advisable to use high-quality surgical instruments and to perform routine checkups before and after surgery.

Editorial Comment: A Road Map for Implementing Transarterial Embolization in the Management of Chronic Joint Pain.

Editorial Comment: A Road Map for Implementing Transarterial Embolization in the Management of Chronic Joint Pain.

Longitudinal validation of the PROMIS-16 in a sample of adults in the United States with back pain.

This longitudinal study evaluates whether the Patient-Reported Outcomes Measurement and Information System (PROMIS)-16 domains capture average change over time comparable to the PROMIS-29 + 2 and have similar associations with change in overall health rating and two disability indices. Data were collected using Amazon's Mechanical Turk at baseline, 3 months, and 6 months among individuals reporting chronic low back pain. The analytic sample includes respondents who completed baseline and at least one follow-up assessment (N = 1137). We estimated latent growth models for eight PROMIS domains and compared growth parameters between the PROMIS-16 and PROMIS 29 + 2 with a z-test. Additionally, for each domain, random intercept and slope scores for individuals were computed for the PROMIS-29 + 2 and PROMIS-16 and correlated to estimate concordance. Using growth parameters for physical function and pain interference, we predicted average change in the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMDQ), the overall health rating, and compared regression coefficients between the PROMIS-16 and PROMIS 29 + 2. All growth models fit the data well. Intercept and slope parameters were statistically comparable (p's > 0.05) in magnitude across all domains between the PROMIS-16 and PROMIS-29 + 2. Correlations between random intercept and slope scores for individuals across domains were high. Additionally, the regression coefficients between slopes for pain interference and physical function and ODI, RMDQ, and overall health rating were statistically comparable (p's > 0.05) between the PROMIS-16 and PROMIS 29 + 2. Results provide between-level support for the longitudinal and predictive validity of the PROMIS-16. Similar average baseline scores and changes over time were observed between PROMIS-16 and PROMIS-29 + 2. Further, average change estimates comparably predicted average change in distal outcomes. This work provides evidence supporting the utility of the PROMIS-16 as a viable, short-profile option for use in clinical and research settings.

The superiority trial of Baduanjin training on patients chronic low back pain: a study protocol for a randomized controlled trial.

CNSLBP accounts for 85% of all LBP cases and impairs physical health, quality of life, and work productivity, posing a significant health and economic burden. Baduanjin (BDJ) exercises are traditional Chinese Qi Gong mind-body exercises that have been practiced for over 1,000 years. However, the standard BDJ protocol established by the State Sports General Administration does not stimulate core muscles, limiting the effectiveness of low back pain rehabilitation. Therefore, it is necessary to improve the original BDJ protocol. This 24-week single-center, single-blind, parallel-group randomized control superiority trial will allocate 100 patients into two groups (control and intervention) at a 1:1 ratio. The patients in the control group will perform the standard BDJ protocol established by the State Sports General Administration. The patients in the patients in the control group will perform the standard BDJ protocol established by the State Sports General Administration. The intervention group will perform intervention. The primary outcomes will be Quebec back pain disability scale. Secondary outcomes will include visual analog scale pain scores, Surface electromyography. The assessments of the tests will be performed at four time points. Adverse events will be recorded faithfully during the study. This randomized control trial is the first to compare a standard BDJ protocol and an optimized protocol in patients with CNSLBP. This study can help guide rehabilitation programs. Chinese Clinical Trial Registry, ChiCTR2200065618, Registered on 10 Nov. 2022. This protocol is the first version 1, which was approved on 26 Aug 2022.

Chronic ischemic gastropathy as an unusual cause of abdominal pain

Abstract Ischaemic gastropathy is a rare condition with a highly variable clinical spectrum. Its presentation varies from chronic abdominal pain to fatal cases of fulminant gastric ischaemia if it develops abruptly. There are several aetiologies of abdominal pain, however, early diagnosis of this pathology will allow a targeted therapeutic approach, which may improve prognosis and avoid fatal consequences.

Effectiveness of telerehabilitation-based mckenzie method versus manual therapy in low-back pain management: a randomised controlled trial

Abstract Background Studies comparing the effectiveness of telerehabilitation and spinal manual therapy (SMT) for chronic non-specific low-back pain (NSLBP) are limited. This study aimed to compare the efficacy of the telerehabilitation-based McKenzie therapy (TBMT) and SMT among patients with NSLBP. Methods Forty-nine consenting patients randomised into either TBMT (n = 28) or SMT (n = 21) group completed the study. TBMT is a mobile phone-based telerehabilitation involving the ‘McKenzie extension protocol’. SMT is a grade II (10 oscillations) posterior-anterior central vertebral pressure on the offending spinous process. Both interventions were applied thrice weekly for eight weeks, and outcomes were assessed on Pain Intensity (PI), Activity Limitation (AL), Participation Restriction (PR), and Health-related Quality of Life (HRQoL) in the fourth and eighth weeks. Results Within-group comparison across baseline, 4th and 8th week indicate that SMT had a significant effect on PI (F = 132.804, p = 0.001), AL (F = 75.984, p = 0.001), PR (F = 99.428, p = 0.001) and for all the scales of SF-12 except for mental health domain (p &gt; 0.05). Similarly, TBMT had a significant effect on PI (F = 243.631; p = 0.001), AL (F = 85.930; p = 0.001), PR (F = 48.425; p = 0.001), and for all the scales except also for mental health domain (p &gt; 0.05). However, there were no significant differences (p &gt; 0.05) in the treatment effects between SMT and TBMT, except for the ‘health perception’ (p = 0.045) scale at week four and the ‘mental health’ scale (p = 0.023) at week eight. Conclusion Telerehabilitation-based McKenzie method and SMT are effective in chronic NSLBP, with TBMT leading to significantly higher long-term health perception improvement. Trial Registration Pan African Clinical Trial Registry (PACTR202010667228786), Registered 27 October 2020-Retrospectively registered.

Dental Pulp Stem Cell Lysate-Based Hydrogel Improves Diabetic Wound Healing via the Regulation of Anti-Inflammatory Macrophages and Keratinocytes.

The prolonged existence of chronic wounds heightens the risk of patients experiencing chronic pain, necrosis, and amputation. Dental pulp stem cells (DPSCs) have garnered attention due to their potential immunomodulatory and tissue repair regenerative effects in the management of chronic wounds. However, stem-cell-based therapy faces challenges such as malignant differentiation, immune rejection, and long-term effectiveness. To overcome these challenges, we proposed a chronic wound therapy using a hydrogel derived from human-originated dental pulp stem cell lysate (DPSCL). Our data indicate that, with the degradation of the dental pulp stem cell lysate-based hydrogel (DPSCLH), the slowly released cell lysates recruit anti-inflammatory M2 macrophages and promote the proliferation, migration, and keratinization of HacaT cells. In addition, in vivo studies revealed that DPSCLH avoids immune rejection reactions and induces a long-term accumulation of endogenous M2 macrophages. In a mouse model of diabetic wounds, DPSCLH effectively modulates the inflammatory microenvironment around diabetic wounds, promotes the formation of the stratum corneum, and facilitates the healing of wounds, thus holding tremendous potential for the treatment of diabetic wounds.

Relationships between personality factors and DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders

This cross-sectional analytical study aimed to assess the relationship between personality factors and the DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders (TMD). 120 participants (60 females and 60 males) who were diagnosed with pain related TMD according to the Axis I DC/TMD protocol were recruited. The participants were requested to complete four tests including the NEO Five Factor Inventory (NEO-FFI) to assess personality factors and three Axis II DC/TMD tools; the Graded Chronic Pain Scale (GCPS) Version 2.0 to assess TMD pain intensity and pain-related disability, Patient Health Questionnaire-4 (PHQ-4) to assess psychological distress due to TMD pain, and Generalized Anxiety Disorder-7 (GAD-7) to assess patients’ stress reactivity. Results showed that 49.2% of the participants experienced high intensity of characteristic pain, 14.2% reported pain related disability more than 30 days (grade 3 disability days) and had disability scores of 70 or above (grade 3 disability scores), 16.7% demonstrated severe distress, and 18.3% reported severe anxiety due to TMD pain. Females scored higher on all these variables than males (P < .05). Multiple regression analyses indicated that higher extraversion scores, higher agreeableness scores and being a female were associated with higher intensity of characteristic pain (p < .05). Also, higher neuroticism and agreeableness scores were associated with more disability days (p < .05). In addition, higher agreeableness scores were associated with higher disability scores and disability point values (p < .05). Furthermore, lower neuroticism scores and being a female were associated with higher PHQ total scores, while being a female and having a lower level of education were associated with higher GAD total scores (p < .05). In conclusion, personality profiles and gender significantly impact the DC/TMD Axis II scores of psychosocial impairment among patients with pain related TMD.