Costa, Y.M., Porporatti, A.L., Stuginski-Barbosa, J., Bonjardim, L.R., Speciali, J.G., Conti, P.C.R.
There is no clear evidence on how a headache attributed to temporomandibular disorder (TMD) can hinder the improvement of facial pain and masticatory muscle pain. The aim of this study was to measure the impact of a TMD-attributed headache on masticatory myofascial (MMF) pain management. The sample was comprised of adults with MMF pain measured according to the revised research diagnostic criteria for temporomandibular disorders (RDC/TMD) and additionally diagnosed with (Group 1, n = 17) or without (Group 2, n = 20) a TMD-attributed headache. Both groups received instructions on how to implement behavioural changes and use a stabilisation appliance for five months. The reported facial pain intensity (visual analogue scale – VAS) and pressure pain threshold (PPT – kgf cm−2) of the anterior temporalis, masseter and right forearm were measured at three assessment time points. Two-way ANOVA was applied to the data, considering a 5% significance level. All groups had a reduction in their reported facial pain intensity (P<0.001). Mean and standard deviation (SD) PPT values, from 1.33 (0.54) to 1.96 (1.06) kgf cm−2 for the anterior temporalis in Group 1 (P = 0.016), and from 1.27 (0.35) to 1.72 (0.60) kgf cm−2 for the masseter in Group 2 (P = 0.13), had significant improvement considering baseline versus the fifth-month assessment. However, no differences between the groups were found (P>0.100). A TMD-attributed headache in patients with MMF pain does not negatively impact pain management, but does change the pattern for muscle pain improvement.
Journal of Oral Rehabilitation 2016; 43 (3): 161-168.