Self-care behaviors associated with myofascial temporomandibular disorder pain.
OBJECTIVE
To document the frequency of self-care in a clinical sample of patients with myofascial temporomandibular disorder (TMD) pain; report the perceived relief and control of pain for each of the self-care behaviors; and to test for associations between the frequency and efficacy of each self-care behavior and pain, depression and sleep quality, as assessed during a clinical visit, and to determine whether the frequency was associated with changes in pain intensity, depression, and sleep quality 30 days later.


METHODS
The sample consisted of 99 female and 27 male myofascial TMD pain patients who were participants in a multidisciplinary facial pain evaluation program. The subjects participated in a structured interview during a clinical visit and a follow-up telephone interview 30 days later. The interviews included questions about self-care, including resting, relaxation techniques, massage, hot and/or cold packs, home remedies, stretching or exercise, herbal remedies, and the use of vitamins or nutritional supplements for pain.


RESULTS
The passive self-care behaviors, such as resting when experiencing pain (66%) and relaxation techniques (62%), were the most commonly used. Patients reported that hot or cold packs (5.3, 0-to-10 scale) and massage (4.7) provided the greatest relief from pain, whereas resting (4.9), relaxation (4.8), and massage (4.8) resulted in the greatest ability to control pain. The most striking finding was that initial levels of pain or change in pain were not consistently associated with self-care use; however, psychosocial outcomes of depression and sleep quality were associated with self-care frequency and reported efficacy and improved in relation to patient-reported self-care frequency.


CONCLUSIONS
Since people with chronic myofascial TMD pain engage in a range of pain self-care strategies, clinicians need to discuss self-care with patients regularly.
Riley
Joseph L
JL
Department of Community Dentistry and Behavioral Sciences, University of Florida Gainesville, Florida 32610-3628, USA. jriley@dental.ufl.edu
Myers
Cynthia D
CD
Currie
Thomas P
TP
Mayoral
Oliver
O
Harris
Rochelle G
RG
Fisher
Jocelyn A
JA
Gremillion
Henry A
HA
Robinson
Michael E
ME
D000529:Complementary Therapies / Q000379:methods; D003863:Depression / Q000150:complications; D004812:Epidemiologic Methods; D005157:Facial Pain / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D012648:Self Care / Q000379:methods*; D012893:Sleep Wake Disorders / Q000150:complications; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000628:therapy*; D013997:Time Factors