Headache Attributed to Masticatory Myofascial Pain: Clinical Features and Management Outcomes

Author(s)

Costa, Yuri Martins ^[1] ; Porporatti, Andre Luis ^[1] ; Stuginski-Barbosa, Juliana ^[1] ; Bonjardim, Leonardo Rigoldi ^[2] ; Specie, Jose Geraldo ^[3] ; Rodrigues Conti, Paulo Cesar ^[1]

Affiliation

^[1] Univ Sao Paulo, Bauru Sch Dent, Dept Prosthodont, BR-17012901 Bauru, SP - Brazil

^[2] Univ Sao Paulo, Bauru Sch Dent, Dept Biol Sci, BR-17012901 Bauru, SP - Brazil

^[3] Univ Sao Paulo, Sch Med Ribeirao Preto, Dept Neurol, BR-14049 Ribeirao Preto - Brazil

• Document type: Journal article
• Source: JOURNAL OF ORAL & FACIAL PAIN AND HEADACHE; v. 29, n. 4, p. 323-330, 2015.
• Web of Science Citations: 7

Abstract

Aims: To describe the characteristics of headaches attributed to temporomandibular disorders (TMD) and assess the effects of two management strategies used for the management of TMD on headache intensity and frequency. Methods: The initial sample (n = 60) of this randomized controlled trial comprised patients with masticatory myofascial pain according to the Research Diagnostic Criteria for TMD (RDC/TMD), and headache. The patients were divided into two groups: group 1 received only counseling for behavioral changes, and group 2 received counseling and an occlusal appliance. A 5-month follow-up period included three assessments. TMD-related headache characteristics, eg, headache intensity (scored on a visual analog scale {[}VAS]) and frequency were measured by a questionnaire. Two-way analysis of variance, chi-square, Friedman, and Mann-Whitney tests were used to test for differences considering a 5% significance level. Results: The main clinical features of headache attributed to masticatory myofascial pain were the long duration (>= 4 hours), frontotemporal bilateral location, and a pressing/tightening quality. Forty-one subjects (group 1, 17 subjects; group 2, 24 subjects) were included in the final analysis. There was a reduction in headache intensity and frequency, with no significant differences between groups (P >.05). The mean (+/-SD) baseline VAS was 7.6 (+/-2.2) for group 1 and 6.5 (+/-1.6) for group 2; final values were 3.1 (+/-2.2) (P <.001) and 2.5 (+/-2.3) (P <.001), respectively. Conclusion: Headache attributed to masticatory myofascial pain was mainly characterized by long duration, frontotemporal bilateral location, and a pressing/tightening quality. Also, counseling and behavioral management of masticatory myofascial pain improved headache, regardless of the use of an occlusal appliance. (AU)

• FAPESP's process: 11/04441-6 - Diagnostic characterization of secondary headaches to temporomandibular disorders in masticatory muscles: a controlled study
• Grantee: Yuri Martins Costa
• Support Opportunities: Scholarships in Brazil - Master