Increased pain sensitivity of the upper extremities of TMD patients with myalgia to experimentally-evoked noxious stimulation – fibromyalgia research

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The purpose of this study was to examine whether or not

temporomandibular disorder (TMD) patients with chronic

masticatory myalgia have increased pain sensitivity at remote

sites outside of the head and neck region, and to evaluate

whether the endogenous pain inhibitory systems triggered

ischemic pain functions favorably in those patients. Twenty

female TMD patients with chronic myalgia and 20 controls

participated in this study. Ischemic pain was produced to

activate endogenous opioids. The pain threshold time, pain

tolerance time, pain intensity and pain unpleasantness were

compared between the TMD patients and controls. The pressure

pain thresholds in the hand were also compared before,

between, and immediately after the ischemic pain. The TMD

patients showed higher severe pain intensity and

unpleasantness values and had lower pressure pain thresholds

in the hand.

Although both groups showed an increase in the

pressure pain threshold, there was less of an increase in the

pressure pain threshold in the TMD patients than in the

controls. These findings indicate that TMD patients have

increased pain sensitivity at remote sites, and also indicate

additional evidence that the endogenous opioid systems may

become impaired in TMD patients with chronic masticatory


Kashima K, Rahman OI, Sakoda S, Shiba R