Is Temporomandibular Pain in Chronic Whiplash-Associated Disorders Part of a More Widespread Pain Syndrome?

Visscher, Corine M.; Hofman, Nico; Mes, C.A.J.; Lousberg, Richel; Naeije, M.

doi:10.1097/01.ajp.0000125264.40304.8c

Cited by 22 publications

(16 citation statements)

References 12 publications

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“…16,21 Such a rationale is therefore recommended for future studies, as trigeminal sensory disturbances in WAD patients indeed may be part of a widespread phenomenon, in analogy with jaw pain in WAD being part of a widespread pain syndrome. 24 In patients with localized jaw pain and dysfunction, temporomandibular disorders, thermal pain thresholds, but not detection thresholds, were reported to differ from healthy subjects in trigeminal and extra-trigeminal regions. 25 …”

Section: Discussionmentioning

confidence: 99%

Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders

2013

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There is a close functional relationship between the jaw and neck regions and it has been suggested that trigeminal sensory impairment can follow whiplash injury. Inclusion of manageable routines for valid assessment of the facial sensory capacity is thus needed for comprehensive evaluations of patients exposed to such trauma. The present study investigated facial thermal thresholds in patients with chronic whiplash-associated disorders (WADs) with both a qualitative method and quantitative sensory testing (QST). Ten women with pain and dysfunction following a whiplash injury were compared to 10 healthy age-matched women. Thermal detection thresholds were assessed by qualitative chair-side testing and by QST according to the method-of-limits. Seven test sites in the facial skin (overlying each trigeminal branch bilaterally, and the midpoint of the chin) were examined. The detection warm and cold thresholds were defined as the mean values of 10 individual thresholds. For the WAD patients, the qualitative assessment demonstrated both reduced and increased sensitivity compared to the healthy, whereas QST systematically showed significantly higher detection thresholds (i.e., decreased sensitivity) for both cold and warm stimuli. For the individuals who were assessed as having increased sensitivity in the qualitative assessment, the QST displayed either normal or higher thresholds, i.e., decreased sensitivity. The results suggest that QST is more sensitive for detecting thermal sensory disturbances in the face than a qualitative method. The impaired thermal sensitivity among the patients corroborates the notion of altered thermal detection capacity induced by WAD-related pain.

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Section: Discussionmentioning

confidence: 99%

Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders

2013

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“…It has been suggested that TMD after a whiplash trauma may develop over time, rather than being part of an acute syndrome . This notion is based on the fact that most studies in acute whiplash patients report a lower prevalence of TMD pain compared with studies based on chronic WAD patient groups . When comparing different study populations after whiplash injury, it should also be remembered that a majority with an acute whiplash injury will recover and that the individuals who develop long‐term symptoms report greater initial pain and disability .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of whiplash trauma in TMD patients: a systematic review

Häggman‐Henrikson

Rezvani

List

2013

J of Oral Rehabilitation

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The purpose of this systematic review was to describe the prevalence of whiplash trauma in patients with temporomandibular disorders (TMDs) and to describe clinical signs and symptoms in comorbid TMD/whiplash compared with TMD localised to the facial region. A systematic literature search of the PubMed, Cochrane Library and Bandolier databases was carried out for articles published from 1 January 1966 to 31 December 2012. The systematic search identified 129 articles. After the initial screening of abstracts, 32 articles were reviewed in full text applying inclusion and exclusion criteria. Six studies on the prevalence of neck trauma in patients with TMD met the inclusion criteria and were included in the review. Two of the authors evaluated the methodological quality of the included studies. The reported prevalence of whiplash trauma ranged from 8·4% to 70% (median 35%) in TMD populations, compared with 1·7-13% in the non-TMD control groups. Compared with patients with TMD localised to the facial region, TMD patients with a history of whiplash trauma reported more TMD symptoms, such as limited jaw opening and more TMD pain, and also more headaches and stress symptoms. In conclusion, the prevalence of whiplash trauma is higher in patients with TMD compared with non-TMD controls. Furthermore, patients with comorbid TMD/whiplash present with more jaw pain and more severe jaw dysfunction compared with TMD patients without a history of head-neck trauma. These results suggest that whiplash trauma might be an initiating and/or aggravating factor as well as a comorbid condition for TMD.

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“…Dynamic three dimensional modelling shows little evidence to support the contention that there is damage to the masticatory apparatus during whiplash (Perez del Palomar and Doblare, 2008). Moreover, it has been suggested that whiplash may lead to widespread body pain and that TMD may just be one expression rather than a specific outcome of whiplash (Visscher et al , 2005).…”

Section: Pathophysiology Of Pompmentioning

confidence: 99%

Persistent orofacial muscle pain

Benoliel

Svensson

et al. 2011

Oral Diseases

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The pathophysiology of persistent orofacial myalgia has been the centre of much controversy. In this article we suggest a novel descriptive term; Ôpersistent orofacial muscle pain' (POMP) and review current evidence that supports the hypothesis that the induction of POMP involves the interplay between a peripheral nociceptive source in muscle, a faulty central nervous system component and decreased coping ability. In this context it is widely accepted that a complex interaction of variable intrinsic and extrinsic factors act to induce POMP and dysfunction.

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Is Temporomandibular Pain in Chronic Whiplash-Associated Disorders Part of a More Widespread Pain Syndrome?

Abstract: The higher prevalence of widespread pain and psychologic distress in patients with chronic whiplash-associated disorder suggests that the higher prevalence of temporomandibular disorder pain in these patients is part of a more widespread chronic pain disorder.

Cited by 22 publications

References 12 publications

Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders

Altered thermal sensitivity in facial skin in chronic whiplash-associated disorders

Prevalence of whiplash trauma in TMD patients: a systematic review

Persistent orofacial muscle pain

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