Headache Exacerbates Pain Characteristics in Temporomandibular Disorders

Author(s)

Costa, Yuri Martins ^{[1, 2]} ; Alves da Costa, Dayse Regina ^[3] ; de Lima Ferreira, Ana Paula ^[4] ; Porporatti, Andre Luis ^{[5, 1]} ; Svensson, Peter ^{[6, 7]} ; Rodrigues Conti, Paulo Cesar ^{[8, 9]} ; Bonjardim, Leonardo Rigoldi ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Bauru Orofacial Pain Grp, Bauru - Brazil

^[2] Univ Sao Paulo, Bauru Sch Dent, Dept Biol Sci, Sect Head & Face Physiol, Al Octavio Pinheiro Brizolla 9-75, BR-17012901 Bauru - Brazil

^[3] Univ Fed Sergipe, Dept Physiotherapy, Sao Cristovao - Brazil

^[4] Univ Fed Pernambuco, Dept Physiotherapy, Recife, PE - Brazil

^[5] Univ Fed Santa Catarina, Dept Dent, Florianopolis, SC - Brazil

^[6] Aarhus Univ, Dept Dent & Oral Hlth, Sect Orofacial Pain & Jaw Funct, Aarhus - Denmark

^[7] Karolinska Inst, Dept Dent Med, SCON, Huddinge - Sweden

^[8] Univ Sao Paulo, Bauru Sch Dent, Dept Prosthodont, Bauru - Brazil

^[9] Univ Sao Paulo, Bauru Official Pain Grp, Bauru - Brazil

• Document type: Journal article
• Source: JOURNAL OF ORAL & FACIAL PAIN AND HEADACHE; v. 31, n. 4, p. 339-345, FAL 2017.
• Web of Science Citations: 5

Abstract

Aims: To evaluate the impact of headache in adults with masticatory myofascial pain (MMP) on the outcome variables clinical pain (ie, self-reported pain intensity and pressure pain sensitivity), sleep quality, and pain catastrophizing. Methods: A total of 97 patients with MMP were diagnosed with co-existing headache (MMPH group, n = 50) or without headache (MMP group, n = 47) according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The outcome parameters were the Pittsburgh Sleep Quality Index (PSQI); the Catastrophizing Thoughts subscale of the Pain-Related Self-Statement Scale (PRSS-C); pressure pain thresholds (PPTs) of the masseter and anterior temporalis muscles; and self-reported facial pain intensity measured on a O to 10-cm visual analog scale (VAS). Student t test for independent samples (alpha = 1.2%) and factorial analysis of variance (ANOVA) (alpha = 5%) were used to analyze the data. Results: The MMPH group showed significantly impaired sleep quality (mean +/- standard deviation {[}SD] PSQI score 9.1 +/- 3.5) compared with the MMP group (7.2 +/- 3.4; P =.008). Subscale scores on the PRSS-C were significantly higher in the MMPH (2.1 +/- 1.2) than in the MMP group (1.6 +/- 1.4, uncorrected P =.048). Also, the PPTs (kgf/cm(2)) of the masseter and anterior temporalis muscles were significantly lower in the MMPH group (1.52 +/- 0.53; 1.29 +/- 0.43, respectively) than in the MMP group (2.09 +/- 0.73; 1.70 +/- 0.68, respectively; P <.001), with no differences in self-reported facial pain intensity. Factorial analyses further indicated that chronic migraine was associated with poorer sleep quality (P =.003) and that tension-type headache patients had lower PPTs in the anterior temporalis muscle (P =.041) in comparison with nonheadache patients. Conclusion: Co-existence of headache further exacerbates clinical characteristics in patients with painful TMD, which implies involvement of common mechanisms and pathways of vulnerability in these patients. (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
• FAPESP's process: 15/09913-4 - The effect of cutaneous afferents in the mechanical somatosensory profile of masticatory myofascial pain.
• Grantee: Yuri Martins Costa
• Support Opportunities: Scholarships in Brazil - Post-Doctoral