Pain measurement in TMD patients: evaluation of precision and sensitivity of different scales

Abstract

The aim of this study was to evaluate the precision and sensitivity of four different pain rating scales in 59 temporomandibular disorders (TMD) patients. The capacity of describing changes in symptoms during treatment was also addressed. All patients were asked to answer four pain scales: Visual Analogue Scale (VAS), Numerical Scale (NS), Behaviour Rating Scale (BRS) and Verbal Scale (VS). Two measurements were taken before any treatment. After beginning it, follow-ups and repeated measurements were taken 1 week, 15 days, and every month for 6 months. Statistical analysis showed significant differences (P < 0.05) for all scales, but the NS (P > 0.05), when the two initial measurements were analysed. Regarding the sensitivity, all pain scales demonstrated general symptom improvement of 30-50%, when initial and final figures were compared (P < 0.01). Also, the most significant improvement occurred in the first 2 months after beginning the management programme. Authors concluded that the NS was more accurate to measure reproducibility of pain. As for the capacity of expressing changes during the treatment, all scales demonstrated symptom decrease of 30-50% in a period of 6 months. Caution when analysing the results is recommended because of the subjective aspect of pain measurement, the absence of a 'gold standard' for comparison and the natural fluctuation of TMD symptoms.

Pressure pain threshold and pain perception in temporomandibular disorder patients: is there any correlation?

“…The VAS was a 100-mm line in which the patient recorded pain intensity by marking a point on the line between the two extremes where the left extreme of the scale is marked "no pain" and the right one is marked "the worst imaginable pain". VAS is a simple, efficient, reliable and valid method to measure pain intensity and is extensively used in clinical settings and researches 18,19 . PPT was measured using a pressure digital algometer with a 1 cm 2 flat-circular shape tip at one end (Kratos ® Equipamentos Industriais).…”

Electromyographic Activity of the Cervical Flexor Muscles in Patients With Temporomandibular Disorders While Performing the Craniocervical Flexion Test: A Cross-Sectional Study

“…In addition, all included participants were asked to report specific characteristics regarding their jaw problem (eg, onset, duration of symptoms, treatments received) and their intensity of pain in the jaw (VAS score) 49,[55][56][57][58] and to complete the Neck Disability Index (NDI), 59,60 the JFS, 61 and a questionnaire for history of jaw pain used by the RDC/TMD. 45 In addition, participants were asked to complete the Chronic Pain Grade Disability Questionnaire for TMD used by the RDC/TMD to evaluate the level of chronic disability due to TMDs.…”

Orofacial pain: basic mechanisms and implication for successful management

“…However, an accurate diagnosis, elimination of contributing factors, necessary pharmacotherapeutics, physical therapy and patient compliance can lead to successful management. Conti et al 4 have demonstrated a decrease of about 50% in pain severity of chronic TMD patients, in spite of the type of pain measurement or type of treatment.…”