A Facility-Based Study of Severity of Pain Among Patients with Temporomandibular Myofascial Pain Syndrome

  • M Okoh
  • N Onyia
  • O Azeez
  • DS Okoh
Keywords: Myofascial pain syndromee, Pain assessment, Temporomandibular joint, Visual Analogus Scale

Abstract

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.

References

Wright EF, North SL. Management and treatment of temporomandibular disorders: a clinical perspective. J Man Manip Ther 2009; 17: 247-254. doi:10.1179/106698109791352184.

Oyetola EO, Adesina OM, Oluwadaisi A, Adewale A, Adewole O, Anizoba E. Temporomandibular joint pain: Clinical presentations and response to conservative treatments in a Nigerian Tertiary Hospital. J Int Soc Prev Community Dent 2017; 7: 98-103. doi:10.4103/jispcd.JISPCD_7_17.

Anitha A, Babu NA, Sankari SL, Malathi L. Myofascial pain dysfunction syndrome - A Review. Biomed Pharmacol J 2016; 9. doi:10.1007/s40122-013-0006-y.

Wang JR, Pan X, Mi CB. Anatomy of temporomandibular joint and condyle position in Uygur adult patients evaluated with cone-beam CT. Shanghai Kou Qiang Yi Xue 2016; 25: 461–464.

Dimitroulis G. Temporomandibular disorders: A clinical update. BMJ 1998; 317: 190-194. doi:10.1136/bmj.317.7152.190.

American Academy of Orofacial Pain: Guidelines for Assessment, Diagnosis and Management. de Leeuw R. (Editor). 4th Edition Chicago. Quintessence. 2008.

Otuyemi OD, Owotade FJ, Ugboko VI, Ndukwe KC, Olusile OA. Prevalence of signs and symptoms of temporomandibular disorders in young Nigerian adults. J Orthod 2000; 27: 61-65. doi:10.1093/ortho/27.1.61.

Fricton JR, Kroening R, Haley D, Siegert R. Myofascial pain syndrome of the head and neck: a review of clinical characteristics of 164 patients. Oral Surg Oral Med Oral Pathol 1985; 60: 615-623. doi:10.1016/0030-4220(85)90364-0.

Katayayan PA, Katayayan MK, Shah RJ, Patel G. Efficacy of appliance therapy on temporomandibular disorder-related facial pain and mandibular mobility: A randomized controlled study. J Indian Prosthodont Soc 2014; 14: 251–261. doi:10.1007/s13191-013-0320-4.

Van Selms MK, Lobbezoo F, Visscher CM, Naeije M. Myofascial temporomandibular disorder pain, parafunction and psychological stress. J Oral Rehabil 2008; 35: 45–52. doi:10.1111/j.1365-2842.2007.01795. x.

Zakrzewska JM. Facial Pain: Neurological and non-Neurological. J Neurol Neurosurg Psychiatr 2002; 72: 27-32. doi:10.1136/jnnp.72.suppl_2. ii27.

Omoregie FO, Okoh M. Pattern of temporomandibular pain dysfunction syndrome in a Nigerian population. J Med Invest Pract 2014; 9: 116-119.

Eweka O, Ogundana O, Agbelusi G. Temporomandibular pain dysfunction syndrome in patients attending Lagos University Teaching Hospital, Lagos, Nigeria. J West Afr Coll Surg 2016; 6: 70–87.

Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent Clin N Am. 2013; 57: 465-479. doi:10.1016/j.cden.2013.04.006.

Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for Clinical Research Applications: Recommendations of the International RDC/TMD Consortium Network and orofacial pain special interest Group. J Oral Facial Pain Headache 2014; 28: 6–27. doi:10.11607/jop.1151.

Vickers ER, Cousins MJ, Woodhouse A. Pain description and severity of chronic Orofacial Pain Conditions. Austral Dent J 1998; 43: 403-409. doi:10.1111/j.1834-7819. 1998.tb00200. x.

Soyannwo OA, Amanor-Boadu SD, Sanya AO, Gureje O. Pain assessment in Nigerians--Visual Analogue Scale and Verbal Rating Scale compared. West Afr J Med 2000; 19: 242-245.

Abubaker AO, Raslan WF, Sotereanos GC. Estrogen and progesterone receptors in temporomandibular joint discs of symptomatic and asymptomatic persons: a preliminary study. J Oral Maxillofac Surg. 1993; 51:1096–1100. doi:10.1016/s0278-2391(10)80448-3.

Wadhwa S, Kapila S. TMJ Disorders: future innovations in diagnostics and therapeutics. J Dent Educ 2008; 72: 930–947.

Osayande O, Okoh M, Itua JO. A review of temporomandibular disorders (TMDs) among patients attending the oral medicine clinic in the University of Benin Teaching Hospital (UBTH). Nig J Dent Res 2019 4: 69-75.

Monteiro NM, Balogun SK, Oratile KN. Managing stress: The influence of gender, age and emotion regulation on coping among university students in Botswana. Int J Adolesc Youth 2014; 19: 153–173. doi:10.1080/02673843.2014.908784.

Poluha RL, Grossmann E, Iwaki LCV, Uchimura TT, Santana RG, Iwaki FL. Myofascial trigger points in patients with temporomandibular joint disc displacement with reduction: a cross-sectional study. J Appl Oral Sci 2018; 26: e20170578. http://dx.doi.org/10.1590/1678-7757-2017-0578.

Ogunlewe MO, Agbelusi GA, Gbotolorun OM, James O. A review of temporomandibular joint disorders (TMD's) presenting at the Lagos University Teaching Hospital. Nig Q J Hosp Med 2008; 18: 57–60.

Mujakperuo HR, Watson M, Morrison R, Macfarlane TV. Pharmacological interventions for pain in patients with temporomandibular disorders. Cochrane Database Syst Rev 2010; 10: CD004715. doi:10.1002/14651858.CD004715.

Gonzalez-Perez LM, Infante-Cossio P, Granados-Nuñez M, Urresti-Lopez FJ. Treatment of temporomandibular myofascial pain with deep dry needling. Med Oral Patol Oral Cir Bucal 2012; 17: e781‐e785. doi:10.4317/medoral.17822.

Milano V, Desiate A, Bellino R, Garofalo T. Magnetic resonance imaging of temporomandibular disorders: classification, prevalence and interpretation of disc displacement and deformation. Dentomaxillofac Radiol 2000; 29: 352-361. doi:10.1038/sj/dmfr/460055.

Bagis B, Ayaz EA, Turgut S, Durkan R, Ozcan M. Gender difference in the prevalence of signs and symptoms of temporomandibular joint disorders: a retrospective study on 243 consecutive patients. Int J Med Sci 2012; 9: 539-544. doi:10.7150/ijms.4474.

Witzel AL, Costa JE, Bolzan MC, Carli ML, Nunes TB, Di Matteo RC, et al. Correlation between gender, temporomandibular joint disc position and clinical findings in patients with temporomandibular disorder. Med Expr 2015; 2: M150402. http://www.dx.doi.org/10.5935/MedicalExpress.2015.04.02.

Han W, Kwon SC, Lee YJ, Park C, Jang EC. The associations between work-related factors and temporomandibular disorders among female full-time employees: findings from the Fourth Korea National Health and Nutrition Examination Survey IV (2007-2009). Ann Occup Environ Med 2018; 30: 42. doi:10.1186/s40557-018-0253-9.

Published
2020-11-24
Section
Original Research