title: Headache attributed to masticatory myofascial pain: impact on facial pain and pressure pain threshold.
abstract: 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 5 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 = 0·013), had significant improvement considering baseline versus the 5th-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.
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.|Department of Dentistry, Section of Orofacial Pain and Jaw Function, Aarhus University, Aarhus, Denmark.|Scandinavian Center for Orofacial Neurosciences (SCON), Bauru, Brazil.
authors.forename: Y M
authors.initials: YM
authors.lastname: Costa
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: A L
authors.initials: AL
authors.lastname: Porporatti
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Stuginski-Barbosa
authors.affiliation: Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: L R
authors.initials: LR
authors.lastname: Bonjardim
authors.affiliation: Department of Neurology, School of Medicine at Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.
authors.forename: J G
authors.initials: JG
authors.lastname: Speciali
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: P C R
authors.initials: PC
authors.lastname: Conti
mesh_terms: D000328:Adult; D005157:Facial Pain / Q000534:rehabilitation*; D005260:Female; D006261:Headache / Q000209:etiology*; D006801:Humans; D008297:Male; D008410:Masticatory Muscles / Q000502:physiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000502:physiology*; D013706:Temporomandibular Joint Dysfunction Syndrome / Q000150:complications*; D055815:Young Adult
keywords: diagnosis; myofascial pain; occlusal splint; secondary headache; temporomandibular joint disorders