Association between signs of hyperalgesia and reported frequent pain in jaw-face and head

Abstract

Objective: To analyze the relationship between different sites of elicited pain to muscle palpation (PtP), and reported frequent pain in jaw-face and head. Materials and methods: The analysis was based on an epidemiological sample of 1200 randomly selected individuals, of which 779 (65%) both completed a questionnaire and participated in a clinical examination. The questionnaire addressed the presence of pain in the jaw-face region and headache, respectively. Part of the clinical examination entailed palpation of the jaw, neck, shoulder, arm, thumb and calf muscles. Logistic regression was applied with pain and headache as dependent variables. A p-value < .05 determined statistical significance. Results: Five percent of participants reported frequent pain in jaw-face, and 17% reported frequent headaches. In the regression analysis, frequent headaches were significantly associated with jaw muscle PtP (OR 2.1, CI 1.4-3.4), regional PtP (OR 4.5, CI 2.6-7.6), and generalized PtP (OR 6.1, CI 2.2-17.0). Jaw-face pain was significantly associated with regional PtP (OR 5.3, CI 2.2-13.0) and generalized PtP (OR 30.1, CI 9.3-97.0). The relationship between pain prevalence and PtP showed a doseresponse pattern. Conclusions: The study indicates that frequent jaw-face pain and headache are primarily associated with signs of regional and widespread hyperalgesia, which may be linked to the central sensitization mechanism. Signs of widespread hyperalgesia should be accounted for in the diagnostic algorithms when examining patients with pain in the jaw, face, and head regions.

Exercise therapy improves pain and mouth opening in temporomandibular disorders: A systematic review with meta-analysis

“…14 Temporomandibular pain affects approximately 10% of adults 15 and can radiate to different structures in orofacial, head and neck areas, and cause other symptoms, such as tinnitus, earaches, 16 headaches 17 or hyperalgesia in neck and trapezius area. 18…”

“…14 Temporomandibular pain affects approximately 10% of adults 15 and can radiate to different structures in orofacial, head and neck areas, and cause other symptoms, such as tinnitus, earaches, 16 headaches 17 or hyperalgesia in neck and trapezius area. 18 Currently, conservative approach, such as pharmacotherapy, splints and physiotherapy including exercises, prevails over surgery, since it is less aggressive and generally produces satisfactory clinical results. 19 At first, pharmacotherapy is prescribed to reduce temporomandibular joint inflammation and pain.…”