Abstract
Our aim was to describe the referred pain patterns and size of areas of trigger points
(TrPs) in the masticatory and neck-shoulder muscles of women with myofascial temporomandibular
disorders (TMD). Twenty-five women with myofascial TMD and 25 healthy matched women
participated. Bilateral temporalis, deep masseter, superficial masseter, sternocleidomastoid,
upper trapezius and suboccipital muscles were examined for TrPs by an assessor blinded
to the subjects' condition. TrPs were identified with manual palpation and categorized
into active and latent according to proposed criteria. The referred pain areas were
drawn on anatomical maps, digitalized, and measured. The occurrence of active (P < .001) and latent TrPs (P = .04) were different between groups. In all muscles, there were significantly more
active and latent TrP in patients than controls (P < .001). Significant differences in referred pain areas between groups (P < .001) and muscles (P < .001) were found: the referred pain areas were larger in patients (P < .001), and the referred pain area elicited by suboccipital TrPs was greater than
the referred pain from other TrPs (P < .001). Referred pain areas from neck TrPs were greater than the pain areas from
masticatory muscle TrPs (P < .01). Referred pain areas of masticatory TrPs were not different (P > .703). The local and referred pain elicited from active TrPs in the masticatory
and neck-shoulder muscles shared similar pain pattern as spontaneous TMD, which supports
the concept of peripheral and central sensitization mechanisms in myofascial TMD.
Perspective
The current study showed the existence of multiple active muscle TrPs in the masticatory
and neck-shoulder muscles in women with myofascial TMD pain. The local and referred
pain elicited from active TrPs reproduced pain complaints in these patients. Further,
referred pain areas were larger in TMD pain patients than in healthy controls. The
results are also in accordance with the notion of peripheral and central sensitization
mechanisms in patients with myofascial TMD.
Key words
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Article info
Publication history
Published online: May 24, 2010
Accepted:
March 5,
2010
Received in revised form:
February 25,
2010
Received:
January 19,
2010
Identification
Copyright
© 2010 American Pain Society. Published by Elsevier Inc. All rights reserved.
