Patients suffering from a chronic psychophysiological orofacial pain disorder, Myofascial Pain Dysfunction Syndrome, were compared with normal control subjects in their reaction to tonic pain stimulation. A signal detection analysis of the data was employed to assess sensitivity and response bias in the perception of pain. The patient group had lower pain thresholds, were less able to discriminate varying intensities of pressure stimulation and demonstrated a greater tendency to report pain as compared to normal control subjects. Possible physiological and psychological mechanisms that could account for the results are discussed.
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Treatment of the myofascial pain-dysfunction syndrome: psychological aspects
Myofascial pain-dysfunction syndrome is a stress-related disorder that involves muscle hyperactivity. Psychological treatments should: reduce muscle tension by relaxation procedures, modify the psychological antecedents to the muscle tension, and modify the psychological consequences to the muscle hyperactivity. The scope of the treatment for the myofascial pain-dysfunction syndrome should be commensurate with the scope of the problem. Patients with brief transient pain, usually associated with discrete problems, should have commensurate, brief, limited interventions, such as a relaxation therapy practiced at home via a tape recording. Patients with long-term problems should have commensurate, longer, more extensive interventions that perhaps include modifying the behavior, the antecedents, and the consequences. These issues may be those that predict failure of treatment by the dentist who uses an occlusal therapy as well as the psychologist who uses a relaxation therapy.
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