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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six different pain rating scales, including a "pain relief scale", were compared in 80 patients suffering acute orofacial pain. Pain intensity measurements were made before and after a 30 min period of afferent stimulation (TENS/vibration and placebo). A good correlation was found between pain scores derived from the pain relief scale, visual analogue-, numerical- and graphic rating scales. The verbal rating scale did not perform well. The pain relief scale and the numerical rating scale are interesting alternatives to the established visual analogue scale.
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PMID:Pain intensity measurements in patients with acute pain receiving afferent stimulation. 325 76

Patients with complex orofacial pain conditions often do not respond as expected to dental care. This article discusses the many psychoanalytic factors that are involved in the pain experience of these patients.
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PMID:Psychological components of pain. 331 11

This article highlights recent advances in our knowledge of the peripheral and central neural mechanisms underlying orofacial pain. It reviews recent research that has identified the critical neural elements and processes associated with the transmission of sensory information related to pain in the mouth and face, as well as recent studies that have improved our understanding of the pathways and mechanisms involved in the modulation of pain.
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PMID:Neurophysiology of orofacial pain. 331 12

The successful diagnosis of orofacial pain depends on the following: 1. An accurate and detailed history of the pain 2. A detailed clinical examination of the face and associated organs 3. A thorough knowledge of those conditions that may produce facial pain In regard to the last requirement, Sir William Osler's maxim should always be remembered "What you don't know--you won't diagnose."
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PMID:Differential diagnosis of orofacial pain. 331 14

This research describes the extent of variability in diagnosis and treatment of temporomandibular disorders (TMD) and relates this variability to treatment outcomes. A health maintenance organization sequentially referred 145 patients with orofacial pain and dysfunction to two TMD clinics. The two clinics differed substantially in their use of tomography (applied to 28% vs. 64% of all patients), and varied moderately in diagnoses assigned to the patient groups. There was large variation in selection of treatments including appliances for bruxism (64% vs. 5%), mandibular repositioning (10% vs. 25%), and joint stabilization (3% vs. 30%); anti-inflammatory medications (44% vs. 19%) and analgesics (16% vs. 2%); and subsequent referral for dental or orthodontic treatment (1% vs. 42%). The differences in diagnostic and therapeutic practice that were found were not associated with important differences in patient-reported pain and dysfunction at 1-year follow-up. These data indicate the need for systematic approaches to identifying, evaluating, and modifying variation in health care practices for common presenting problems lacking reliable methods of evaluation and generally accepted clinical standards for choice of treatments.
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PMID:Temporomandibular disorders. Variation in clinical practice. 335 27

The pain-relieving effect of vibratory stimulation, using different stimulus parameters, and placebo stimulation in acute orofacial pain is reported. The influence of 10-, 100-, and 200-Hz vibrations on pain reduction was studied in 96 patients; two different probe sizes were used. 54 out of 76 patients, receiving vibrations at any of the above frequencies, reported relief of pain to some extent, while only 6 out of 20 patients receiving placebo treatment experienced pain alleviation. No significant differences were found between the different frequencies and probe sizes used regarding the pain-relieving effect. However, placebo stimulation was significantly less effective than any kind of vibratory stimulation. Induction time for pain relief was significantly shorter using the larger probe as compared to using the smaller probe, regardless of frequency. The results indicate that the vibratory frequency (10-200 Hz) for activation of pain-inhibitory mechanisms is not critical in acute orofacial pain. Also, spatial summation from vibration-sensitive afferents seems to be of importance for a fast activation of the inhibitory systems.
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PMID:Influence of stimulus frequency and probe size on vibration-induced alleviation of acute orofacial pain. 354 87

The placebo effect is capable of relieving pain and affective disorders. The mechanism of placebo action is pharmacologic and psychologic, being related to the patient-practitioner relationship and the clinical treatment setting. The placebo effect also occurs with all active or real treatments. The effects of placebos in management of orofacial pain and MPD syndrome have been demonstrated. Placebo effects may account for a third to two-thirds of responses in mandibular dysfunction. Many treatments suggested for management of pain may be acting solely as placebos. Health professionals active in management of pain should understand and use the placebo effect to improve patient care.
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PMID:Understanding placebos in dentistry. 620 32

Review of the literature indicates that most routine orofacial dysfunctions are characterized by deep pain. Various disorders of the masticatory systems, particularly musculoskeletal conditions, are thought to be triggered by occlusal disharmonies. The pain component develops following a pattern of bruxism, muscle hyperactivity, fatigue and spasm. Treatment for most disorders has been to modify the occlusion, although the rational for doing so appears questionable.CRITICAL ISSUES IN THE FIELD OF OCCLUSION RELATED TO OROFACIAL PAIN ARE REVIEWED: occlusal disharmonies, coincidence of retruded-intercuspal contact positions, non-working side interferences, maximum intercuspation of teeth, occlusal adjustment, and occlusal appliances.The studies reviewed fail to support the clinical objective of obtaining equal contact at retruded and intercuspal positions and that the lateral pterygoid muscles stabilize the temporomandibular joint. The relationship between non-working side interferences and pain dysfunction is also not readily supported by controlled studies. Occlusal adjustment appears to be unsatisfactory as a modality for management of pain: not all patients improved following treatment, some relapse occurs even with the most stable contacts, and other treatments such as intra-articular injections of corticosteroids reduced symptoms more readily. Occlusal splints seem to reduce most clinical signs and symptoms on both a short-term and long-term basis. Placement of mandibular orthopedic repositioning appliances results in reduction of pain in some patients, but usually this treatment is followed by extensive rehabilitation.Six major areas are suggested for clinical studies that attempt to relate occlusion to management of orofacial pain. These include: establishment of an ideal jaw position, sequencing of symptoms in the pain history, relationship of pain to other symptoms, development of physiological methods to assess how occlusal modification affects pain perception and pain tolerance, and determination of which treatment modalities produce the most effective relief of pain.
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PMID:Occlusal therapy in the management of chronic orofacial pain. 637 67

The paranasal sinuses are a common source of maxillofacial pain. When the sphenoid sinus is involved, 13 different structures can also be affected. The various neuralgias are usually easily recognized by their classic symptoms. Temporal arteritis must be diagnosed early in order to prevent blindness. The temporomandibular joint syndrome remains the most misdiagnosed and misunderstood orofacial pain.
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PMID:Maxillofacial pain. 646 48

The pain relieving effect of vibratory stimulation was studied in 731 patients suffering from acute pain (135 patients) or chronic pain (596 patients). Most of the patients had previously undergone treatments of various kinds without sufficient pain relief. The effect of vibratory stimulation was assessed before, during and after stimulation using different rating scales. About 70% of the patients reported reduction of pain during vibratory stimulation. In many patients there was a clear relation between the degree of reduction of pain and the intensity of pain before the beginning of stimulation. In general, relief of pain by more than 50% during stimulation was obtained in the patients who reported light, light to moderate, or moderate pain. The patients with moderate to severe, or severe pain before stimulation generally reported a reduction of pain of 50% or less. The best pain reducing site was found to be either the area of pain or close to it, the antagonistic muscle or a trigger point near the painful area. In most patients suffering from musculoskeletal pain the best pain reducing effect was obtained when the vibratory stimulation was applied with moderate pressure (at which contact was achieved with underlying bone) at a frequency of 50-150 Hz. To obtain a maximal duration of pain relief the stimulation had to be applied for 30-45 minutes. Many of the patients experienced pain relief lasting for more than 3 hours. It may be noticed that in many patients the pain relief lasted for 12 hours or more. There was a good correlation between the degree of pain relief and its duration. In the patients who experienced a pain reduction of 50% or less the pain relief generally lasted for less than 6 hours while in the patients who experienced pain relief of more than 50% it lasted for more than 6 hours. In comparison with high or low frequency TENS, vibratory stimulation was found to be as effective and in some patients even more effective in reducing chronic musculoskeletal or orofacial pain. The effect of 20 Hz, 100 Hz and 200 Hz vibratory stimulation, high frequency TENS, low frequency TENS and "placebo" vibratory stimulation was examined in various chronic musculoskeletal pain syndromes. 82% of the patients experienced a relief of pain with any of the above mentioned methods; 47% of the patients experienced a reduction of pain with vibratory stimulation or TENS stimulation.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Vibratory stimulation for the alleviation of chronic pain. 660 24


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