4.1 Article

Association between signs of hyperalgesia and reported frequent pain in jaw-face and head

Journal

ACTA ODONTOLOGICA SCANDINAVICA
Volume 79, Issue 3, Pages 188-193

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/00016357.2020.1814963

Keywords

Epidemiology; myofascial pain; temporomandibular disorders; headaches; diagnosis

Funding

  1. Vasterbotten County Council

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The study reveals that frequent jaw-face pain and headache are primarily associated with signs of regional and widespread hyperalgesia, potentially linked to central sensitization mechanism. Signs of widespread hyperalgesia should be taken into consideration in diagnostic algorithms for patients with pain in the jaw, face, and head regions.
Objective To analyze the relationship between different sites of elicited pain to muscle palpation (PtP), and reported frequent pain in jaw-face and head. Materials and methods The analysis was based on an epidemiological sample of 1200 randomly selected individuals, of which 779 (65%) both completed a questionnaire and participated in a clinical examination. The questionnaire addressed the presence of pain in the jaw-face region and headache, respectively. Part of the clinical examination entailed palpation of the jaw, neck, shoulder, arm, thumb and calf muscles. Logistic regression was applied with pain and headache as dependent variables. Ap-value < .05 determined statistical significance. Results Five percent of participants reported frequent pain in jaw-face, and 17% reported frequent headaches. In the regression analysis, frequent headaches were significantly associated with jaw muscle PtP (OR 2.1, CI 1.4-3.4), regional PtP (OR 4.5, CI 2.6-7.6), and generalized PtP (OR 6.1, CI 2.2-17.0). Jaw-face pain was significantly associated with regional PtP (OR 5.3, CI 2.2-13.0) and generalized PtP (OR 30.1, CI 9.3-97.0). The relationship between pain prevalence and PtP showed a dose-response pattern. Conclusions The study indicates that frequent jaw-face pain and headache are primarily associated with signs of regional and widespread hyperalgesia, which may be linked to the central sensitization mechanism. Signs of widespread hyperalgesia should be accounted for in the diagnostic algorithms when examining patients with pain in the jaw, face, and head regions.

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