Lec 4 Flashcards
How many pain-related TMD and Headaches have been validated?
4
The 4 pain-related TMD and Headaches that have been validated.
1) Arthralgia
2) Myalgia
3) Myofascial pain with referral
4) Headache attributed to TMD
Diagnostic criteria for TMD symptoms
Must have had the pain in the last 30 days that’s modified by function and parafunction.
The most common pain condition.
Myalgia
Facial muscles that are more prevalent in a pain condition.
Temporalis and Masseter
Pain of muscle origin that’s affected by jaw movement, function, or parafunction, and replication of this pain occurs with provocation testing of the masticatory muscles.
Myalgia
Have this when you can:
1) Locate the pain to temporalis or masseter.
2) Have pain during palpation of temporalis or masseter, or during vertical range of motion (MAO and MUO)
Myalgia
All pain-related TMD and headaches have this in clinical finding in common.
Confirmation of pain in temporalis and masseter.
All pain-related TMD and headaches have this history in common.
1) Chief complaint of pain
2) Pain modified by function or parafunction
Myofascial pain with referral goes where?
BEYOND the boundary of the muscle being palpated.
Diagnose the disorder:
1) Confirm that pain is located in temporalis and masseter.
2) Report familiar pain occurs when you palpate temporalis and masseter
3) Report pain at a site BEYOND the boundary of the muscle being palpated.
Myofascial pain with referral
Pain of MUSCLE origin with referral of pain beyond the boundary of the muscle being palpated.
Myofascial pain with referral.
Pain of JOINT origin that’s affected by jaw movement, function, or parafunction, and replication of this pain occurs with provocation testing of the TMJ.
Arthralgia
How do you test for familiar pain in arthralgia?
1) Palpate the lateral pole or around it.
2) MUO or MAO, right or left lateral, or protrusive movement (Movement in ANY direction).
Has pain in any direction, and when you palpate the lateral pole.
Arthralgia
Headache in the temple area that’s caused by TMD.
And headache that’s modified with jaw movement, function, or parafunction.
Headache attributed to TMD.
These two have pain in ANY direction of movement.
Arthralgia and Headache attributed to TMD
Have pain when you palpate temporalis OR
During movement in ANY direction.
Headache attributed to TMD
Headache TMD pain is in this area.
Temple
These facial muscles are activated during vertical range of motion.
Masseter and Temporalis
If you have headache associated TMD, you need to have this.
Myalgia or Arthralgia
Sensitivity for these pain-related conditions is above what?
80
Used to diagnose muscle spasms.
EMG
Sudden, involuntary, reversible tonic contraction of a muscle.
Muscle spasm
Immediate onset of myalgia and immediate limited range of motion associated with this.
Muscle spasm
Shortening of the muscle due to fibrosis of the tendons, ligaments, or muscle fibers.
Contracture
1) Pain is present if the muscle is over-extended.
2) Hx of radiation, trauma, or infection
3) Progressive loss of ROM.
4) MUO and MAO are limited
Contracture
This range of motion is affected in contracture.
Vertical
Muscle pain with inflammation or infection.
Myositis
Can get this from direct trauma or autoimmune disease.
Myositis
Calcification of the muscle can occur
Myositis ossificans
This has local myalgia, edema, erythema, increased temperature, and inflammatory markers.
Myositis ossificans
Enlargement of one or more muscles.
Hypertrophy
This is usually NOT associated with pain, and is secondary to overuse and/or chronic tensing of the muscles.
Familiar/genetic in origin.
Hypertrophy
Pain-related changes should be viewed as adaptive bc they help to prevent further damage and promote healing.
Pain adaptation model
This theory says that muscle pain becomes chronic because stimulation of nociceptors by an initial injury leads to tonix excitation of motorneurons (hyperactivity).
Leads to spasm, fatigue, and overwork, and that this process leads to further stimulation of nociceptors, resulting in a pain-spasm-pain cycle.
Vicious Cycle Theory
This reduces muscle contraction.
Pain
The effect of pain on motor activity relies on the complex interaction of distinctive bio-psychosocial characteristics, as well as the anatomical and functional complexity of the individual sensory-motor system.
Integrated Pain Adaptation Model
Usually NOT associated with pain.
Hypertrophy
