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Published in: The Journal of Headache and Pain 1/2015

Open Access 01-12-2016 | Research article

Pain profiling of patients with temporomandibular joint arthralgia and osteoarthritis diagnosed with different imaging techniques

Authors: Simple Futarmal Kothari, Lene Baad-Hansen, Lars Bolvig Hansen, Niels Bang, Leif Hovgaard Sørensen, Helle Wulf Eskildsen, Peter Svensson

Published in: The Journal of Headache and Pain | Issue 1/2015

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Abstract

Background

Clinical differentiation between pain mechanisms of temporomandibular joint (TMJ) arthralgia and osteoarthritis (OA) is challenging. The aims were to compare somatosensory function at the TMJs and conditioned pain modulation (CPM) effects between TMJ arthralgia and OA patients diagnosed clinically and based on different imaging techniques and age- and gender-matched healthy controls (n = 41).

Methods

Patients (n = 58) underwent standard clinical examination and three different TMJ imaging modalities. After each examination, they were classified into arthralgia or OA based on the findings. TMJ region somatosensory testing was performed in all participants. Z-scores were calculated for patients based on healthy reference data. CPM was tested by comparing pressure pain thresholds (PPTs) at TMJ and thenar (control) before, during and after the application of painful and nonpainful cold stimuli. Data were analyzed using analyses of variance.

Results

Somatosensory abnormalities were commonly detected in both patient groups. Assessment of somatosensory function at the TMJ revealed that arthralgia patients were less sensitive to warmth, cold and tactile stimuli than OA patients (P < 0.048). OA patients showed pressure hyperalgesia compared with arthralgia patients (P = 0.025). There was a significant CPM effect at both test sites during painful cold application in all groups (P < 0.001). There was no significant difference in the relative CPM effect between groups except for clinically diagnosed arthralgia patients showing reduced CPM effect compared with controls (P = 0.047).

Conclusions

Pain profiles including somatosensory function differed between TMJ arthralgia and OA patients although CPM effects were similar in patients and controls. Thus, different TMJ pain conditions may share common pain mechanisms but the present study for the first time also indicated that differential pain mechanisms could be involved.
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Metadata
Title
Pain profiling of patients with temporomandibular joint arthralgia and osteoarthritis diagnosed with different imaging techniques
Authors
Simple Futarmal Kothari
Lene Baad-Hansen
Lars Bolvig Hansen
Niels Bang
Leif Hovgaard Sørensen
Helle Wulf Eskildsen
Peter Svensson
Publication date
01-12-2016
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2015
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-016-0653-6

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