The Influence of Myofascial Temporomandibular Disorder Pain on the Pressure Pain Threshold of Women During a Migraine Attack

Fiamengui, Lívia Maria Sales Pinto; Carvalho, João José Freitas de; Cunha, Carolina Ortigosa; Bonjardim, Leonardo Rigoldi; Filho, Jorge Francisco Fiamengui; Conti, Paulo César Rodrigues

doi:10.11607/jop.1059

Cited by 7 publications

(3 citation statements)

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“…However, muscle pain is also an evident clinical manifestation in this population (51). Low PPT values of masticatory muscles have been reported during a migraine attack in myofascial TMD-free women, which support basic findings of muscle pain as a consequence of central neuron hyperexcitability (52). Therefore, even though migraine and TMD are considered different entities, they can present with overlapping signs.…”

Section: Diagnostic Methodssupporting

confidence: 64%

Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

Conti

Costa

Gonçalves

et al. 2016

J of Oral Rehabilitation

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There are relevant clinical overlaps between some of the painful temporomandibular disorders (TMD) and headache conditions that may hamper the diagnostic process and treatment. A non-systematic search for studies on the relationship between TMD and headaches was carried out in the following databases: PubMed, Cochrane Library and Embase. Important pain mechanisms contributing to the close association and complex relationship between TMD and headache disorders are as follows: processes of peripheral and central sensitisation which take place in similar anatomical areas, the possible impairment of the descending modulatory pain pathways and the processes of referred pain. In addition, the clinical examination does not always provide distinguishing information to differentiate between headaches and TMD. So, considering the pathophysiology and the clinical presentation of some types of headache and myofascial TMD, such overlap can be considered not only a matter of comorbid relationship, but rather a question of disorders where the distinction lines are sometimes hard to identify. These concerns are certainly reflected in the current classification systems of both TMD and headache where the clinical consequences of diagnosis such as headache attributed to or associated with TMD are uncertain. There are several similarities in terms of therapeutic strategies used to manage myofascial TMD and headaches. Considering all these possible levels of interaction, we reinforce the recommendation for multidisciplinary approaches, by a team of oro-facial pain specialists and a neurologist (headache specialist), to attain the most precise differential diagnosis and initiate the best and most efficient treatment.

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Section: Diagnostic Methodssupporting

confidence: 64%

Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

Conti

Costa

Gonçalves

et al. 2016

J of Oral Rehabilitation

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“…One study revealed that migraine attacks are related to trigger points in the masticatory muscles, which cause myofascial pain [30]. Calixtre et al identified that pain and headache were strongly associated with general health in individuals with migraine with TMJ disorders [31].…”

Section: Discussionmentioning

confidence: 99%

Changes and Associations between Cervical Range of Motion, Pain, Temporomandibular Joint Range of Motion and Quality of Life in Individuals with Migraine Applying Physiotherapy: A Pilot Study

et al. 2021

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Background and Objectives: The aim of this study was to assess the effects of physiotherapy with aerobic exercise together with temporomandibular joint range of motion exercises (supervised) and physiotherapy with aerobic exercise only (unsupervised), also to review the correlations between neck movements, pain, temporomandibular joint range of motion movements and quality of life in individuals with migraine. Methods: The flexion, extension and lateral flexion of the cervical spine were measured in degrees with a mechanical goniometer and pressure pain thresholds with algometer. Quality of life was assessed with the SF-36 questionnaire and temporomandibular joint range of motion with a centimeter. Results: The study showed statistically significant cervical flexion results in both groups (p < 0.05), masticatory muscle results and temporomandibular joint range of motion between the groups (p < 0.05). A correlation between left upper trapezius muscle pain and cervical lateral flexion was observed in the intervention group. Physical activity correlated with cervical extension, activity limitation due to physical ailments and general health. A correlation between temporomandibular joint and right-side masticatory muscles pain was found. A correlation between upper trapezius muscle pain and left- as well as right-side temporalis muscles were found in the control group. Strong correlations were found between pain and activity limitation due to physical ailments and emotional state. The temporomandibular joint range of motion strongly correlated with activity limitation due to physical ailments. Conclusions: Physiotherapy based on aerobic exercises together with temporomandibular joint exercises was more effective than physiotherapy based on aerobic exercise for decreasing pain, increasing pressure pain thresholds and cervical range of motion.

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“…Several biological, clinical, and psychological factors 3,4,33 associated with TMD are recognized in this clinical case. The relationship among pain‐related TMD, migraine 34 , stress 35 , anxiety, 35 and sleep quality 15 has already been established. Genetic variants are potential risk factors for chronic TMD due to the modulation of central and peripheral pathways, 25 and SNPs investigations reported here may corroborate with findings previously discussed on the literature.…”

Section: Discussionmentioning

confidence: 99%

Insights for temporomandibular disorders management: From psychosocial factors to genetics—A case report

Braga

Fiamengui

Silveira

et al. 2020

Special Care in Dentistry

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AimsThis case report aimed to discuss the multifactorial etiology and also the management of temporomandibular disorders (TMD) by addressing important associated psychosocial and biological factors, emphasizing the interaction between these factors and a probable genetic predisposition.Methods and resultsA 21‐year‐old female patient was evaluated according to Research Diagnostic Criteria for TMD and diagnosed with arthralgia, myofascial pain, disc displacement without reduction, and temporomandibular joint (TMJ) degenerative disease. TMJ alterations were confirmed through magnetic resonance imaging and cone‐beam computed tomography. Pressure pain threshold of masticatory structures was evaluated using a pressure algometer. Sleep bruxism, poor sleep quality, migraine with aura, mild anxiety, and history of facial trauma were also identified through anamnesis and clinical examination. Following this, genetic analysis was performed to evaluate the presence of single nucleotide polymorphisms (SNPs) already associated with TMD: SNP COMT Val158Met (rs4680), MMP1‐1607 (rs1799750), and tumor necrosis factor alpha‐308 (rs1800629), which were all present. A personalized treatment for TMD management was performed, and it included self‐management programs, occlusal appliance therapy, pharmacotherapy, anxiety management, and stress control. An 8‐year follow‐up demonstrated long‐term stabilization of TMJ degenerative disease.ConclusionGenetic evaluation, added to anamnesis and clinical examination, could be useful for TMD prognosis and management.

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The Influence of Myofascial Temporomandibular Disorder Pain on the Pressure Pain Threshold of Women During a Migraine Attack

Cited by 7 publications

References 0 publications

Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

Changes and Associations between Cervical Range of Motion, Pain, Temporomandibular Joint Range of Motion and Quality of Life in Individuals with Migraine Applying Physiotherapy: A Pilot Study

Insights for temporomandibular disorders management: From psychosocial factors to genetics—A case report

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