Psychosocial and Somatosensory Factors in Women with Chronic Migraine and Painful Temporomandibular Disorders

Abstract

Introduction. Psychosocial and somatosensory factors are involved in the pathophysiology of chronic migraine (CM) and chronic temporomandibular disorders (TMD). Objective. To compare and assess the relationship between pain catastrophizing and kinesiophobia in patients with CM or chronic TMD. Method. Cross-sectional study of 20 women with CM, 19 with chronic TMD, and 20 healthy volunteers. Pain catastrophizing and kinesiophobia were assessed. The level of education, pain intensity, and magnitude of temporal summation of stimuli in the masseter (STM) and tibialis (STT) muscles were also evaluated. Results. There were significant differences between the CM and chronic TMD groups, compared with the group of asymptomatic subjects, for all variables (p < .05) except kinesiophobia when comparing patients with CM and healthy women. Moderate correlations between kinesiophobia and catastrophizing (r = 0.46; p < .01) were obtained, and the strongest association was between kinesiophobia and magnification (r = 0.52; p < .01). The strongest associations among physical variables were found between the STM on both sides (r = 0.93; p < .01) and between the left and right STT (r = 0.76; p < .01). Conclusion. No differences were observed in pain catastrophizing and kinesiophobia between women with CM and with chronic TMD. Women with CM or chronic TMD showed higher levels of pain catastrophizing than asymptomatic subjects.

Endogenous pain modulation in chronic temporomandibular disorders: Derivation of pain modulation profiles and assessment of its relationship with clinical characteristics

“…No association of EPM responses with pain characteristics such as pain duration or pain intensity was found in the present study similarly to previous studies . Contrary to studies that found association of TSP with anxiety and pain catastrophising, no statistically significant correlation was found for any of the psychosocial measures included in this study. A recent meta‐analysis also reported no significant correlations between CPM responses and anxiety, depression or pain catastrophising, although certain psychological factors seem to be associated with modality‐specific CPM responses in healthy individuals …”

“…Pain facilitation was clearly induced over both face and hand for both groups, however somewhat counterintuitively, only increased mean hand TSP response for TMD cases relative to controls was found. Studies using pinprick stimuli to induce TSP found varied results when comparing TMD cases to pain‐free controls: one reported similar results of non‐facilitated TSP when tested over the face and facilitated TSP over the hand, another study found increased TSP responses on both face (trigeminal) and leg (non‐trigeminal) test sites while a third study showed non‐increased TSP over the face, trapezius and hand (both non‐trigeminal) test sites . Despite these conflicting results, a meta‐analysis showed increased TSP in TMD cases relative to pain‐free controls when assessed using varied test stimuli and body sites .…”

“…[19][20][21] One study reported positive correlation of TSP over non-trigeminal test site (fingers) and anxiety in TMD cases, 19 and another reported that TSP over the face (skin over masseter muscles) was positively correlated with pain intensity and catastrophising. 22 Given conflicting results from studies reporting EPM testing in TMD cases and the PMP concept potential, the present study had three aims: (a) Test the facilitatory and inhibitory aspects of EPM in chronic TMD cases and matched pain-free controls; (b) Derive PMPs for each participant based on individual EPM responses for pain facilitation (TSP) and pain inhibition (CPM); and (c) Categorise clinical characteristics of both TMD cases and pain-free controls based on their individual PMP.…”

“…Association of EPM responses and clinical factors in TMD cases has been investigated with the majority of studies reporting no association of EPM and pain characteristics such as pain intensity or duration . One study reported positive correlation of TSP over non‐trigeminal test site (fingers) and anxiety in TMD cases, and another reported that TSP over the face (skin over masseter muscles) was positively correlated with pain intensity and catastrophising …”

Tactile trigeminal region acuity in temporomandibular disorders: A reliability and cross‐sectional study

“…TMDs are the main cause of nonodontogenic oro‐facial pain, with considerable prevalence and chronicity rates . They also involve high costs in terms of both greater disability and socioeconomic level and are frequently associated with psychological disorders such as pain catastrophism …”