Moss, R. A., Garrett, J. C., & Chiodo, J. F. (1982). Myofascial pain dysfunction and temporomandibular joint dysfunction syndromes; Parameters, etiology, and treatment. Psychological Bulletin, 2, 331-346. (original) (raw)
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Journal DOI: 10.7439/ijasr Review Article The Enigma of Myofascial Pain Dysfunction Syndrome
2016
Myofascial Pain Dysfunction Syndrome (MPDS) is one of the most common and important cause of the orofacial pain. Patients with temporomandibular joint and muscle pain gradually learn to live with the symptoms although they have been exposed to a variety of treatments. In some instances the symptoms have been aggravated by the treatment, while other patients have recovered without treatment. Masticatory muscle fatigue and spasm are responsible for the cardinal symptoms of pain, tenderness, clicking, and limited function that characterize the MPD Syndrome. The symptoms of a typical temporomandibular joint dysfunction are classified as (a) pain and its sequelae, (2) clicking and crepitus, and (3) irregularities of mandibular movement. The pain can be unilateral or bilateral with varying degree of pain. Mandibular deviation is a third characteristic often evident in temporomandibular joint patients. Mandibular deviation, in this instance, refers to the deviation from rest position to mo...
The Enigma of Myofascial Pain Dysfunction Syndrome
International Journal of Advances in Scientific Research, 2015
Introduction:Myofascial Pain Dysfunction Syndrome (MPDS) is one of the most common and important cause of the orofacial pain.Patients with temporomandibular joint and muscle pain gradually learn to live with the symptoms although they have been exposed to a variety of treatments. In some instances the symptoms have been aggravated by the treatment, while other patients have recovered without treatment.Masticatory muscle fatigue and spasm are responsible for the cardinal symptoms of pain, tenderness, clicking, and limited function that characterize the MPD Syndrome.The symptoms of a typical temporomandibular joint dysfunction is classified as (a) pain and its sequelae, (2) clicking and crepitus, and (3) irregularities of mandibular movement.The pain can be unilateral or bilateral with varying degree of pain.Mandibular deviation is a third characteristic often evident in temporomandibularjoint patients. Mandibular deviation, in this instance, refers to the deviation from rest position...
International Journal of Environmental Research and Public Health, 2021
This review elaborates on the aetiology, diagnosis, and treatment of temporomandibular (TMD) myofascial pain syndrome (MPS) regulated by psychosocial factors. MPS impairs functioning in society due to the accompanying pain. Directed and self-directed biopsychosocial profile modulation may be beneficial in the treatment of MPS. Moreover, nutrition is also a considerable part of musculoskeletal system health. A fruit and vegetable diet contributes to a reduction in chronic pain intensity because of its anti-inflammatory influence. Cannabidiol (CBD) oils may also be used in the treatment as they reduce stress and anxiety. A promising alternative treatment may be craniosacral therapy which uses gentle fascia palpation techniques to decrease sympathetic arousal by regulating body rhythms and release fascial restrictions between the cranium and sacrum. MPS is affected by the combined action of the limbic, autonomic, endocrine, somatic, nociceptive, and immune systems. Therefore, the treat...
Annals of Health Research, 2020
Background: Myofascial pain syndrome is the most common temporomandibular joint (TMJ) disorder. Objective: To measure pain severity among patients with temporomandibular myofascial pain syndrome using the Visual Analogue Scale (VAS), and to relate pain severity to age and gender. Methods: A cross-sectional study of patients who presented with TMJ pain and were diagnosed with TMJ myofascial pain syndrome was conducted. Data were collected using a structured questionnaire and were statistically analysed. Results: Out of a total of 603 patients, 18 (3.0%) had temporomandibular myofascial pain syndrome. They were aged 22-78 years with female preponderance (11; 61.1%) and a female-to-male ratio of 1.6:1. The majority of the patients had mild pain (7/18; 38.9%). The mean VAS score for the patients in this study was 5.8+2.6. The female patients experienced more severe pain (5/11; 45.4%), compared to males. Conclusion: There was a female preponderance in TMJ myofascial pain syndrome, with a mean VAS pain score of 5.8+2.6. Severe pain was mostly reported by female patients while the male patients often present with mild pain.
Temporomandibular disorders. A case-control study
Medicina Oral Patología Oral y Cirugia Bucal, 2012
Objective: To compare the risk factors and clinical manifestations of patients with temporomandibular disorders (TMDs) diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (axis I) versus an age and gender matched control group. Study Design: A total of 162 patients explored according to the RDC/TMD (mean age 40.6±18.8 years, range 7-90; 11.1% males and 88.9% females) were compared with 119 controls, measuring differences in TMD risk factors (sleep disturbances, stress, psychoactive medication, parafunctions, loss of posterior support, ligament hyperlaxity) and clinical variables (joint sounds, painful muscle and joint palpation, maximum aperture). Results: Myofascial pain (MFP) (single or multiple diagnoses) was the most frequent diagnosis (42%). The most common diagnostic combination was MFP plus arthralgia (16.0%). Statistically significant differences were observed in clenching (OR 2.3; 95%CI: 1.4-3.8) and in maximum active aperture (MAA) on comparing the two groups both globally (TMD vs. controls) (patients 36.7±8.6 mm, controls 43.1±5.8 mm; F=45.41, p = 0.000) and on comparing according to diagnostic categories. MFP explained most of the observed differences in the risk factors: stress perception (OR=1.98;I.C.:1.01-3.89), psychoactive medication (OR=2.21; I.C.:1.12-4.37), parafunctions (OR=2.14;I.C.:1.12-4.11), and ligament laxity (OR=2.6;I.C.:1.01-6.68). Joint sounds were more frequent in patients with MFP (39.7% vs. 24.0%; χ2=4.66; p=0.03), and painful joint palpation was more common in patients with disc displacement with reduction (DDWR)(15.9% vs. 5.0%; χ2 = 5.2; p = 0.02) and osteoarthrosis (20.8% vs. 5.0%; χ2 = 7.0; p = 0.008). Conclusions: There is a high prevalence of signs and symptoms of TMDs in the general population. Significant differences are observed in clenching and MAA between patients and controls considered both globally and for each diagnostic category individually. The analyzed risk factors (except loss of posterior support) show a statistically significant OR for the diagnosis of MFP.
Pattern of Temporomandibular Pain Dysfunction Syndrome
Pakistan Journal of Medical and Health Sciences
Aim: The aim of this analysis was to understand the pattern of temporomandibular pain dysfunction syndrome among patients with TMPDS. Study Design: A descriptive cross-sectional study. Place and Duration: In the department of Oral and Maxillofacial Surgery, PIMS Hospital, Islamabad and Punjab Dental Hospital, Lahore for duration of Four months from 16th January 2021 to 15th May 2021. Methods: A total of 46 patients with a clinical demonstration of TMPDS were enrolled in the analysis. Data was collected on demographic characteristics, major ailments, etiology, history of stress and depression. Results: In this study, 18 (39.1%) of the 46 patients were male and 28 (68.9%) females. 17 to 70 years was the age range of patients with 24.3 ± 12.9 years mean age and 20 (43.5%) subjects in the 10-19 age group and then 9 (19.6%) patients in the 20-29 age group and 3 (6.5%) was observed in the 60-69 age group. Regarding the main complaint, pain was the most prevalent complain noticed in 34(73....
Objective: In a study to the possible role of overuse of the jaw muscles in the pathogenesis of jaw muscle pain, we used a protocol involving concentric and eccentric muscle contractions to provoke a state of delayed-onset muscle soreness (DOMS) in the jaw muscles of healthy individuals. We tested whether the accompanying signs and symptoms would yield the temporary diagnosis of myofascial pain according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD) in these individuals. Methods: Forty persons (mean age ± SD = 27.7 ± 7.5 y) performed six, 5-minute bouts of eccentric and concentric jaw muscle contractions. Before and immediately after the exercise, and 24 hours, 48 hours, and 1 week later, self-reported muscle fatigue and pain, pain-free maximum mouth opening, pressure-pain thresholds, and the number of painful jaw muscle palpation sites were recorded. Results: Significant signs and symptoms of DOMS in the jaw muscles were found, which all had resolved after 1 week. In 31 (77.5%) of the participants, these signs and symptoms also gave rise to a temporary diagnosis of myofascial pain according to the RDC/TMD. Conclusions: The results of this study demonstrate that an experimental protocol involving concentric and eccentric muscle contractions can provoke DOMS in the jaw muscles and the temporary diagnosis of myofascial pain according to the RDC/TMD. The results observed strengthen the supposition that the myofascial pain in TMD patients may be a manifestation of DOMS in the jaw muscles.
Temporomandibular Joint Disorders' Impact on Pain, Function, and Disability CLInICaL InVESTIGaTIOnS
A supplemental appendix to this article is published electronically only at http://jdr.sagepub.com/supplemental. Abstract: The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders (" TMJ intra-articular status "), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability (" TMD impact "). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject's most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], –0.04 to 0.13) for all TMD cases and 0.07 (95% CI, –0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored.