Psychological profile and self-administered relaxation in patients with craniofacial pain: a prospective in-office study

Abstract

IntroductionThe objective of this study was to evaluate the psychological profile of craniofacial pain sufferers and the impact of patient subtype classification on the short-time effectiveness of a self-administered relaxation training.MethodsOne hundred unselected in-office patients (67% females) suffering from chronic facial pain and/or headache with the presumptive diagnose of temporo-mandibular disorder (TMD) completed a questionnaire battery comprising craniofacial pain perception, somatic complaints, irrational beliefs, and pain behavior and were classified into subtypes using cluster analysis. They underwent a self-administered progressive relaxation training and were re-evaluated for pain perception after 3 months.ResultsPain was mild to moderate in the majority of patients. Symptom domains comprised parafunctional activities, temporo-mandibular pain and dysfunction, fronto-temporal headache, head/neck and neck/back pain. Three patient subtypes were identified regarding symptom/dysfunction level: (i) low burden (mild/moderate), (ii) psychosocial dysfunction (moderate/high), (iii) adaptive coping (moderate/mild). Self-rated adherence to the recommended relaxation training was moderate throughout the sample, but self-rated relief was significantly different between clusters. At follow-up, pain intensity was significantly decreased in all patients, whereas pain-related interference was improved only in dysfunctional and adaptive patients. Improvement of symptom domains varied between clusters and was most comprehensive in adaptive patients.ConclusionsIn conclusion, craniofacial pain sufferers can be divided in meaningful subtypes based on their pain perception, irrational beliefs, and pain behaviour. A self-administered relaxation training generally yielded positive effects on pain perception, however the benefit may be greater in patients with more marked symptom impact (both dysfunctional and adaptive).

Integração da Psicologia e Odontologia na DTM: revisão sistematizada

“…Outras formas de técnicas citadas nas abordagens aos pacientes com dor facial crônica ou diagnóstico provável de DTM foi o autorelaxamento. Essa técnica demonstrou ser de fácil aplicação e trouxe resultado positivo sobre a percepção da dor, no entanto, o benefício pode ser maior em pacientes com maiores impactos dos sintomas, tanto disfuncionais quanto adaptativos 23 . Este levantamento evidencia a importância de uma abordagem multiprofissional na assistência ao paciente com DTM, onde o papel do psicólogo é fundamental no diagnóstico correto e acompanhamento do paciente para o sucesso do tratamento.…”

Temporomandibular Myofascial Pain Syndrome—Aetiology and Biopsychosocial Modulation. A Narrative Review

“…The pain intensity diminished in all the patients with craniofacial pain (regardless of the symptom/dysfunction level) after 3-months of PMR exercises. Moreover, there was a noticeable reduction in pain frequency, duration, and interference in individuals with psychosocial dysfunction (moderate/high) and adaptive coping (moderate/mild) [123].…”

“…As noted, there are several techniques that provide a consistent reduction in stress and consequently pain relief [154]. Numerous studies show positive effects of relaxation techniques, CBT, and biofeedback on stress and pain [9,93,94,103,104,112,113,123].…”