Clinical presentations and co-morbid factors of patients with myofascial pain or myalgia of masticatory muscles

Authors

1 Professor, Department of Oral Medicine and Orofacial Pain, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran

2 Assistant Professor, Department of Oral Medicine and Orofacial Pain, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran

3 Associate Professor, Department of Oral Medicine and Orofacial Pain, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran

4 Professor, Director of Orofacial Pain Program, UCLA School of Dentistry, Los Angeles, California, USA

5 Oral and Dental Diseases Research Center AND Kerman Social Determinants on Oral Health Research ‎Center, Kerman University of Medical Sciences, Kerman, Iran

Abstract

BACKGROUND AND AIM: This study was aimed to investigate the clinical presentations and frequencies of co-morbid factors in patients with myofascial pain or myalgia of masticatory muscles.
METHODS: In this retrospective study, the data were obtained from the documents of the patients with myalgia or myofascial pain of the masticatory muscleswho were conceded toKerman Orofacial Pain Clinic, Kerman, Iran. Their clinical presentations and frequencies of possible related comorbid factors were evaluated. The chi-square test, Fisher’s exact test, and t-test were used for comparing the distribution of variables. Analysis of variance (ANOVA) and Tukey's honestly significant difference (HSD) test were also used for comparisons between groups. A P-value ≤ 0.05 was considered statistically significant.
RESULTS: Patients with masticatory muscle myalgia or myofascial painconsisted of 296 individuals, 258 women (87.7%) and 38 men (12.3%) with an average age of 34.00 ± 11.75 years (range: 15-75 years). Temporomandibular disorder (TMD) occurred in 259 (87.5%) patients and 262 (88.5%) subjects had headache. A total of 178 individuals (60.1%) reported pain in three parts of the body and 155 subjects (52.4%) had insomnia. Bruxism, other oral para-functional habits, and poor head and neck postures were found in 156 (52.7%), 167 (56.4%), and 80 (27.0%) subjects, respectively. The frequency of moderate to severe depression and moderate anxiety was 22.0% of our study population.
CONCLUSION: This study stated that the frequency of masticatory muscle pain (MMP) was high in patients with TMD, headache, and psychological disorders and accompanied with insomnia, oral parafunction, and bodily pain.

Keywords

References

  1. Silveira A, Gadotti IC, Armijo-Olivo S, Biasotto-Gonzalez DA, Magee D. Jaw dysfunction is associated with neck disability and muscle tenderness in subjects with and without chronic temporomandibular disorders. Biomed Res Int 2015; 2015: 512792.
  2. Fleckenstein J, Zaps D, Ruger LJ, Lehmeyer L, Freiberg F, Lang PM, et al. Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey. BMC Musculoskelet Disord 2010; 11: 32.
  3. Suvinen TI, Reade PC, Kemppainen P, Kononen M, Dworkin SF. Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain 2005; 9(6): 613-33.
  4. Franco AL, Goncalves DA, Castanharo SM, Speciali JG, Bigal ME, Camparis CM. Migraine is the most prevalent primary headache in individuals with temporomandibular disorders. J Orofac Pain 2010; 24(3): 287-92.
  5. Auvenshine RC. Temporomandibular disorders: Associated features. Dent Clin North Am 2007; 51(1): 105-27.
  6. Lim PF, Smith S, Bhalang K, Slade GD, Maixner W. Development of temporomandibular disorders is associated with greater bodily pain experience. Clin J Pain 2010; 26(2): 116-20.
  7. Lei J, Liu MQ, Yap AU, Fu KY. Sleep disturbance and psychologic distress: Prevalence and risk indicators for temporomandibular disorders in a Chinese population. J Oral Facial Pain Headache 2015; 29(1): 24-30.
  8. Nilsson IM, List T, Drangsholt M. Headache and co-morbid pains associated with TMD pain in adolescents. J Dent Res 2013; 92(9): 802-7.
  9. de Leeuw R. Orofacial pain: Guidelines for assessment, diagnosis, and management. 4th ed. New Malden, Surrey, UK: Quintessence Publishing; 2008.
  10. Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache 2014; 28(1): 6-27.
  11. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia 2013; 33(9): 629-808.
  12. Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med 2008; 4(5): 487-504.
  13. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory--Second edition: BDI-II-PERSIAN. Depress Anxiety 2005; 21(4): 185-92.
  14. Kaviani H, Mousavi AS. Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J 2008; 66(2): 136-40. [In Persian].
  15. Melo CE, Oliveira JL, Jesus AC, Maia ML, de Santana JC, Andrade LS, et al. Temporomandibular disorders dysfunction in headache patients. Med Oral Patol Oral Cir Bucal 2012; 17(6): e1042-e1046.
  16. Cairns BE. The influence of gender and sex steroids on craniofacial nociception. Headache 2007; 47(2): 319-24.
  17. Goncalves DA, Bigal ME, Jales LC, Camparis CM, Speciali JG. Headache and symptoms of temporomandibular disorder: An epidemiological study. Headache 2010; 50(2): 231-41.
  18. Tchivileva IE, Ohrbach R, Fillingim RB, Greenspan JD, Maixner W, Slade GD. Temporal change in headache and its contribution to the risk of developing first-onset temporomandibular disorder in the Orofacial Pain: Prospective Evaluation and Risk Assessment (OPPERA) study. Pain 2017; 158(1): 120-9.
  19. Cady RJ, Glenn JR, Smith KM, Durham PL. Calcitonin gene-related peptide promotes cellular changes in trigeminal neurons and glia implicated in peripheral and central sensitization. Mol Pain 2011; 7: 94.
  20. Stuginski-Barbosa J, Macedo HR, Bigal ME, Speciali JG. Signs of temporomandibular disorders in migraine patients: A prospective, controlled study. Clin J Pain 2010; 26(5): 418-21.
  21. Liljestrom MR, Le Bell Y, Anttila P, Aromaa M, Jamsa T, Metsahonkala L, et al. Headache children with temporomandibular disorders have several types of pain and other symptoms. Cephalalgia 2005; 25(11): 1054-60.
  22. Goncalves MC, Florencio LL, Chaves TC, Speciali JG, Bigal ME, Bevilaqua-Grossi D. Do women with migraine have higher prevalence of temporomandibular disorders? Braz J Phys Ther 2013; 17(1): 64-8.
  23. Goncalves DA, Camparis CM, Franco AL, Fernandes G, Speciali JG, Bigal ME. How to investigate and treat: migraine in patients with temporomandibular disorders. Curr Pain Headache Rep 2012; 16(4): 359-64.
  24. Graff-Radford SB. Temporomandibular disorders and headache. Dent Clin North Am 2007; 51(1): 129-44.
  25. Bevilaqua-Grossi D, Lipton RB, Napchan U, Grosberg B, Ashina S, Bigal ME. Temporomandibular disorders and cutaneous allodynia are associated in individuals with migraine. Cephalalgia 2010; 30(4): 425-32.
  26. Wiesinger B, Malker H, Englund E, Wanman A. Back pain in relation to musculoskeletal disorders in the jaw-face: A matched case-control study. Pain 2007; 131(3): 311-9.
  27. Macfarlane TV, Blinkhorn AS, Davies RM, Kincey J, Worthington HV. Predictors of outcome for orofacial pain in the general population: A four-year follow-up study. J Dent Res 2004; 83(9): 712-7.
  28. Moldofsky H. The significance of the sleeping-waking brain for the understanding of widespread musculoskeletal pain and fatigue in fibromyalgia syndrome and allied syndromes. Joint Bone Spine 2008; 75(4): 397-402.
  29. Yatani H, Studts J, Cordova M, Carlson CR, Okeson JP. Comparison of sleep quality and clinical and psychologic characteristics in patients with temporomandibular disorders. J Orofac Pain 2002; 16(3): 221-8.
  30. Lindroth JE, Schmidt JE, Carlson CR. A comparison between masticatory muscle pain patients and intracapsular pain patients on behavioral and psychosocial domains. J Orofac Pain 2002; 16(4): 277-83.
  31. Ishii H. A study on the relationships between imbalance of stomatognathic function and asymmetry of craniofacial morphology, and the center of gravity of the upright posture. Osaka Daigaku Shigaku Zasshi 1990; 35(2): 517-56. [In Japanese].
  32. Olmos SR, Kritz-Silverstein D, Halligan W, Silverstein ST. The effect of condyle fossa relationships on head posture. Cranio 2005; 23(1): 48-52.
  33. Cuccia A, Caradonna C. The relationship between the stomatognathic system and body posture. Clinics (Sao Paulo) 2009; 64(1): 61-6.
  34. Karibe H, Shimazu K, Okamoto A, Kawakami T, Kato Y, Warita-Naoi S. Prevalence and association of self-reported anxiety, pain, and oral parafunctional habits with temporomandibular disorders in Japanese children and adolescents: A cross-sectional survey. BMC Oral Health 2015; 15: 8.
  35. Lobbezoo F, Lavigne GJ. Do bruxism and temporomandibular disorders have a cause-and-effect relationship? J Orofac Pain 1997; 11(1): 15-23.
  36. Kato T, Thie NM, Huynh N, Miyawaki S, Lavigne GJ. Topical review: Sleep bruxism and the role of peripheral sensory influences. J Orofac Pain 2003; 17(3): 191-213.
  37. Carlsson GE, Egermark I, Magnusson T. Predictors of bruxism, other oral parafunctions, and tooth wear over a 20-year follow-up period. J Orofac Pain 2003; 17(1): 50-7.
  38. Manfredini D, Cantini E, Romagnoli M, Bosco M. Prevalence of bruxism in patients with different research diagnostic criteria for temporomandibular disorders (RDC/TMD) diagnoses. Cranio 2003; 21(4): 279-85.
  39. Ahlberg J, Savolainen A, Rantala M, Lindholm H, Kononen M. Reported bruxism and biopsychosocial symptoms: a longitudinal study. Community Dent Oral Epidemiol 2004; 32(4): 307-11.
  40. Michelotti A, Cioffi I, Festa P, Scala G, Farella M. Oral parafunctions as risk factors for diagnostic TMD subgroups. J Oral Rehabil 2010; 37(3): 157-62.
  41. Gavish A, Halachmi M, Winocur E, Gazit E. Oral habits and their association with signs and symptoms of temporomandibular disorders in adolescent girls. J Oral Rehabil 2000; 27(1): 22-32.
  42. Glaros AG, Hanson AH, Ryen CC. Headache and oral parafunctional behaviors. Appl Psychophysiol Biofeedback 2014; 39(1): 59-66.
  43. Carlson CR, Reid KI, Curran SL, Studts J, Okeson JP, Falace D, et al. Psychological and physiological parameters of masticatory muscle pain. Pain 1998; 76(3): 297-307.
  44. Atasoy HT, Atasoy N, Unal AE, Emre U, Sumer M. Psychiatric comorbidity in medication overuse headache patients with pre-existing headache type of episodic tension-type headache. Eur J Pain 2005; 9(3): 285-91.
  45. Franco AL, Runho GH, Siqueira JT, Camparis CM. Medical conditions and body pain in patients presenting orofacial pain. Arq Neuropsiquiatr 2012; 70(5): 348-51.
  46. Worthington HV, MacFarlane T. Association between orofacial pain and other symptoms: a population-based study. Oral Biosciences and Medicine 2004; 1(1)45-54.
Journal of Oral Health and Oral Epidemiology
Volume 8, Issue 4
November 2019
Pages 190-197

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History

  • Receive Date: 05 January 2020
  • Accept Date: 05 January 2020

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