J Orofac Pain
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To investigate (1) differences in heart rate variability (HRV) indices between masticatory muscle pain (MMP) patients and pain-free controls at rest, during a stressor condition, and during a post-stressor recovery period, and (2) factors including psychological distress, social environment, and family-of-origin characteristics in the MMP sample compared to a pain-free matched control sample. ⋯ These results provide further evidence of physiological activation and emotional responding in MMP patients that differentiates them from matched pain-free controls. The use of HRV indices to measure physiological functioning quantifies the degree of sympathetic and parasympathetic activation. Study results suggest the use of these HRV indices may improve understanding of the role of excitatory and inhibitory mechanisms in patients with MMP conditions.
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Randomized Controlled Trial Comparative Study
Randomized clinical trial of acupuncture for myofascial pain of the jaw muscles.
To evaluate the effectiveness of acupuncture in treating symptoms associated with myofascial pain of the jaw muscles. ⋯ A single acupuncture session using one acupoint at Hegu large intestine 4 significantly reduced most myofascial pain endpoints when compared to sham acupuncture.
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As there is a high correspondence between the experience of trauma and posttraumatic stress disorder (PTSD) symptoms among chronic orofacial pain patients, study objectives included: (1) to document the nature of traumatic experiences and severity of PTSD symptoms among a female sample of orofacial pain patients, (2) to examine the relationship between PTSD symptoms and both pain-related and psychosocial outcomes, and (3) to use structural equation modeling (SEM) to test hypotheses of mediation derived from the Mutual Maintenance Model of chronic pain and PTSD. ⋯ PTSD and depression screening as well as thorough sleep evaluations should be included in the routine assessment for orofacial pain patients and, if appropriate, referrals for treatment of PTSD symptoms should be considered part of the standard of care.
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To use PRISM (Pictorial Representation of Illness and Self Measure), a visual instrument that has recently been developed and validated to assess suffering in patients with chronic physical illness, in orofacial pain patients and test for associations of PRISM with established assessment tools for pain, affective symptoms, and sleep. Of particular interest was the utility of PRISM as a screening tool for severely suffering patients. ⋯ These data add support to the hypothesis that the PRISM task in its paper and pencil version is measuring the burden of suffering. The clinical utility of this simple graphic tool therefore lies in its potential to alert clinicians to a high burden of suffering and thus it may help to identify orofacial pain patients who may benefit from more comprehensive assessment and treatment. Prospective studies are needed to clarify this claim.