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

Craniomandibular pain has five major causes: neurologic, vascular, the temperomandibular joint itself, muscular, and hysterical conversion. When the pain source is purely in the muscles it has been termed MPD (myofascial pain dysfunction) by Laskin. However, when the TMJ itself is also involved it is called TMJ dysfunction-pain syndrome.
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PMID:The etiology, diagnosis, and treatment of TMJ dysfunction-pain syndrome. Part I: Etiology. 29 77

The ability to predict claudication pain during single-stage (S) and progressive (P) treadmill protocols from clinical measurements obtained at rest was examined. Peripheral hemodynamic measurements from the more severely diseased lower limb and medical history data were obtained from 56 claudicant patients during supine rest immediately preceding S (1.5 mph and 7.5% grade) and P (2 mph, 0% grade with 2% increase every 2 min) treadmill protocols. Distance walked to onset of claudication pain (CPD) and to maximal pain (MPD) during both protocols were recorded. The claudication distances during the S protocol were not correlated with either the peripheral hemodynamic or medical history variables. In contrast, CPD and MPD during the P protocol were predicted (P less than 0.05) by ankle/brachial systolic blood pressure index (ABI) (quadratic relationship), laterality of claudication pain (1 = unilateral, 2 = bilateral), and gender (1 = female, 2 = male) from the following regression equations: CDP (m) = 159.9 - (321.8 x ABI) + (445.6 x ABI2) - (93.5 x laterality) + (99.0 x gender), R = 0.74, R2 = 0.55, adjusted R2 = 0.53, SEE = 110.5, P less than 0.0001; and MPD (m) = 83.1 + (195.0 x ABI) + (174.0 x ABI2) - (76.4 x laterality) + (114.2 x gender), R = 0.76, R2 = 0.58, adjusted R2 = 0.55, SEE = 138.3, P less than 0.0001. It is concluded that the regression equations for the prediction of CPD and MPD may be used to quickly estimate the functional severity of peripheral vascular occlusive disease in clinical settings where treadmill testing is not feasible or is impractical.
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PMID:Prediction of claudication pain from clinical measurements obtained at rest. 154 4

The observation that drainage of the MPD in selected cases of severe chronic pancreatitis has a radical benefit on pain reduction supports the hypothesis that pain is mainly due to obstruction of the MPD. Further follow-up study is needed to assess whether endoscopic management can prevent progression of the disease and especially postpone the onset of diabetes and steatorrhea. The iterative character of the endoscopic management is at least an advantage when compared with surgery, which, in principle, might be considered definitive in only one operation. The present excellent results of non-surgical management of chronic pancreatitis suggest that these new procedures will find a prominent role similar to that already achieved for biliary tract procedures. Therapeutic endoscopy of the pancreas and chronic pancreatitis has focused on the 'stone and stricture' nature of the disease, and techniques have developed accordingly.
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PMID:Non-surgical management of severe chronic pancreatitis. 223 84

Studies have shown uniformly that myofascial pain-dysfunction/temporomandibular (MPD/TM) patients have higher electromyographic (EMG) activity in the head-neck muscles than do non-MPD/TM subjects. However, no attempt has been made to use facial EMG data in diagnosing MPD/TM conditions. This paper explicates four concepts that can, in principle, serve to guide individual diagnosis using EMG data. It then reports an experiment in which resting facial EMG data were acquired from MPD patients and control subjects, and it evaluates preliminarily the diagnostic utility of the EMG information. The conclusion is offered that diagnosis via EMG is sufficiently promising to justify additional research.
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PMID:Sensitivity, specificity, and the predictive value of facial electromyographic data in diagnosing myofascial pain-dysfunction. 263 6

The subject of pain is intimately related to that of mandibular function. It is now clear that certain types of temporomandibular disorders, particularly myofascial pain dysfunction, result, in part, from rhythmic muscle activity produced by parafunctional oral habits such as diurnal or nocturnal bruxism. Furthermore, in addition to phasic hyperactivity, evidence also suggests that masticatory muscles of patients with MPD are tonically hyperactive. The pain associated with such hyperactive musculature prompts many patients to seek professional help. This article provides an updated historical review of one important aspect of mandibular function and gives insight into the general "state of the art."
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PMID:Sensory and motor integration during mandibular function. 331 13

This research compares different treatment regimes for the management of chronic facial pain associated with the masticatory musculature. Twenty-one females meeting specific criteria were randomly assigned to one of three treatment conditions: a dental splint and physiotherapy program; a relaxation program utilizing progressive muscle relaxation, biofeedback, and stress management techniques; or a minimal treatment program involving transcutaneous electrical nerve stimulation. Improvement was assessed through a dental examination, self-monitoring of pain, and an assessment of EMG activity during resting and task conditions. Significant changes were obtained in response to all treatment programs. The treatment programs differed only in the relative pattern of treatment effects obtained from the self-report monitoring of pain. The data are consistent with the concept of MPD as a psychological response to stress which maintains chronic pain through increased muscle tension in the jaw.
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PMID:A comparison of treatment modes in the management of myofascial pain dysfunction syndrome. 360 94

Dental patients were classified by experienced dentists as MPD or non-MPD patients. Apart from the symptoms often used as criteria for such a classification, there is a broad range of symptoms and patient characteristics associated with MPD. Because of procedural and methodologic problems, little is known about the strength of these associations. Because reliable knowledge about symptoms and characteristics of MPD is needed for MPD etiology and for adequate treatment evaluation, the present study tried to establish which subjective signs and symptoms differentiate MPD from non-MPD patients. Results of a questionnaire show that 10 items classified 86% of the patients correctly. Among them, restricted mouth opening and sounds at jaw movement had the highest discriminative power. Pain in the jaw area also showed a highly significant difference between the patient groups. When patient selection is based on these criteria, approximately the same patient groups are obtained by a time-consuming dental examination and by a low-cost questionnaire. Results also showed that reported oral habits such as chewing on hard or tough objects and lip-tongue-cheek biting do not differentiate the two groups. Symptoms related to ears and eyes discriminate the groups only marginally. Sleep-related symptoms, with awakening with stiff or painful jaws as the most important item, differentiate patients in a more substantial way. The suggestion from a great number of studies that stress and tension are etiologic factors in MPD is not supported by the present results.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Myofascial pain-dysfunction: subjective signs and symptoms. 386 47

The masseter inhibitory period (silent period) and sensations evoked by tooth-pulp stimulation were examined in 12 healthy subjects and 12 patients with oral-facial pain and mandibular dysfunction (MPD). Trains of 30 pulses were applied to an upper incisor and the threshold intensities for detecting sensation, for detecting pain sensation and for the masseter inhibitory period were determined. Masseter activity was monitored during tooth stimulation by electromyographic recordings from surface electrodes. Electrical tooth stimulation elicited three different configurations of masseter inhibitory periods in both groups: single, double and merged. MPD patients exhibited a greater proportion of single inhibitory periods. The combined average total durations of the three types of configurations were less in MPD. The findings are consistent with the hypothesis that there is an increase in excitability of the central masseter motorneuron pool in MPD, resulting in a reduction in the effective duration of the masseter inhibitory period. The higher incidence of single inhibitory periods in MPD patients also could result from this increased central excitatory state. There was no difference between masseter inhibitory periods evoked in either painful or non-painful muscles, and no particular configuration associated with pain sensation. The findings do not support the hypothesis that nociceptive input contributes to the increase in duration of the silent period in MPD. Although there were no significant differences between masseter inhibitory period threshold, detection thresholds or pain threshold for both groups, MPD patients had detection thresholds higher than their masseter inhibitory thresholds. These effects may be related to differential central neural influences on sensory-discriminative and reflex pathways in the trigeminal system.
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PMID:Masseter inhibitory periods and sensations evoked by electrical tooth pulp stimulation in patients with oral-facial pain and mandibular dysfunction. 695 48

A retrospective survey of a hospital emergency room population seen at an oral and maxillofacial surgery clinic during a 6-month period found 62 patients (2.7% of the total population) with temporomandibular joint disorders. The diagnoses were myofascial pain-dysfunction/temporomandibular joint dysfunction (MPD/TMJ) syndrome (70.9% of the cases) and dislocation (luxation) (22.5% of the cases). The chief complaint was well defined in relation to the diagnoses: facial pain in the MPD/TMJ syndrome cases, and displacement of the mandible in the dislocation cases.
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PMID:Incidence of temporomandibular joint disorders in patients seen at a hospital emergency room. 805 1

One purpose of this clinical study is to establish a relationship between the hyper activity of the digastric muscles and predisposition of an individual to MPDS (myofacial pain dysfunction syndrome). If a population predisposed to MPD could be identified by an early diagnosis, intervention and treatment could eliminate potential pain in adulthood. Secondly, can the employment of electromyography to aid in the diagnosis of patients with MPD be helpful in establishing a program of prevention and treatment? Thirty-one patients, male and female, were randomly selected from among those routinely diagnosed as having myofascial pain dysfunction syndrome by the dental staff at the Long Island Center for Craniofacial Pain. Eighteen patients who did not experience any symptoms of facial pain comprised the control group in the study. This study demonstrated that the average trace readings which indicate the activity of the digastric muscles, as measured by the electromyogram from patients experiencing facial pain were significantly higher than those from patients without pain symptoms. In every instance, the correlation between facial pain and abnormal swallow patterns which are a cause of hyperactivity of the digastrics was confirmed.
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PMID:Prevalence of hyperactive digastric muscles during swallowing as measured by electromyography in patients with myofascial pain dysfunction syndrome. 961 Feb 92


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