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      Myofascial Pain Syndrome and Its Relation to Trigger Points, Facial Form, Muscular Hypertrophy, Deflection, Joint Loading, Body Mass Index, Age and Educational Status

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          A BSTRACT

          Introduction:

          Myofascial pain (MFP) is a type of pain characterized by the presence of a trigger point (TrPs) in taut band of skeletal muscles or its fascia. Based on the current literature, the prevalence of head and neck myofascial pain (HNMFP) varies among different communities. To better understand this condition and its relation to facial form, muscular hypertrophy, deflection, and joint loading, the study aimed at evaluating the prevalence of HNMFP among the population of Jeddah, Saudi Arabia.

          Materials and Methods:

          This was a cross-sectional study to survey a sample of Jeddah residents, Saudi Arabi between the ages of 18–65 for HNMFP who were attending a public event in December 2019. Participants were asked to complete a questionnaire for demographics and history of HMFP signs and symptoms followed by a comprehensive clinical examination including facial form, muscular hypertrophy, maximum vertical opening, and joint loading. In addition, examination of upper quarter muscles was completed using flat or pincer palpation as needed. Data were collected and summarized as frequencies and percentages and group differences were tested using the chi-square statistical method.

          Results:

          A total of 197 participants were examined in this study, in which 136 (69.0%) had signs and symptoms consistent with HNMFP. Study subjects’ educational status was significantly associated with HNMFP ( P = 0.008). Older subjects were more likely to report spontaneous pain whereas younger subjects were more likely to report pain following trauma ( P = 0.049). Older subjects were more likely to have muscular hypertrophy ( P = 0.011), while Younger subjects were more likely to have symmetrical facial form ( P = 0.004). In terms of gender, males were more likely to experience pain aggravation with pressure and cold application whereas females were more sensitive to jaw function ( P = 0.015). Distribution of joint loading showed a statistically significant difference between males and females ( P = 0.008) with females having deflection on opening more frequently compared to males ( P = 0.001). Furthermore, female subjects showed a significantly higher frequency of positive TrPs compared to males.

          Conclusion:

          Based on the current data, HNMFP is a common condition among the population of Jeddah. Factors such as body mass index and educational level were found to be linked to HNMFP. Younger subjects were more likely to have symmetrical facial form while older subjects were more likely to have muscular hypertrophy. The distribution of joint loading showed a statistically significant difference between males and females with females having deflection on opening more frequently compared to males. Further studies with a larger group of patients are needed to confirm these findings.

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          Most cited references 38

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          Sex differences in pain and pain inhibition: multiple explanations of a controversial phenomenon.

           Jeffrey Mogil (2012)
          A clear majority of patients with chronic pain are women; however, it has been surprisingly difficult to determine whether this sex bias corresponds to actual sex differences in pain sensitivity. A survey of the currently available epidemiological and laboratory data indicates that the evidence for clinical and experimental sex differences in pain is overwhelming. Various explanations for this phenomenon have been given, ranging from experiential and sociocultural differences in pain experience between men and women to hormonally and genetically driven sex differences in brain neurochemistry.
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            Classification of chronic pain. Descriptions of chronic pain syndromes and definitions of pain terms. Prepared by the International Association for the Study of Pain, Subcommittee on Taxonomy.

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              A systematic literature review of 10 years of research on sex/gender and experimental pain perception - part 1: are there really differences between women and men?

              The purpose of this systematic review was to summarize and critically appraise the results of 10 years of human laboratory research on pain and sex/gender. An electronic search strategy was designed by a medical librarian and conducted in multiple databases. A total of 172 articles published between 1998 and 2008 were retrieved, analyzed, and synthesized. The first set of results (122 articles), which is presented in this paper, examined sex difference in the perception of laboratory-induced thermal, pressure, ischemic, muscle, electrical, chemical, and visceral pain in healthy subjects. This review suggests that females (F) and males (M) have comparable thresholds for cold and ischemic pain, while pressure pain thresholds are lower in F than M. There is strong evidence that F tolerate less thermal (heat, cold) and pressure pain than M but it is not the case for tolerance to ischemic pain, which is comparable in both sexes. The majority of the studies that measured pain intensity and unpleasantness showed no sex difference in many pain modalities. In summary, 10 years of laboratory research have not been successful in producing a clear and consistent pattern of sex differences in human pain sensitivity, even with the use of deep, tonic, long-lasting stimuli, which are known to better mimic clinical pain. Whether laboratory studies in healthy subjects are the best paradigm to investigate sex differences in pain perception is open to question and should be discussed with a view to enhancing the clinical relevance of these experiments and developing new research avenues. Copyright © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
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                Author and article information

                Journal
                J Int Soc Prev Community Dent
                J Int Soc Prev Community Dent
                JISPCD
                Journal of International Society of Preventive & Community Dentistry
                Wolters Kluwer - Medknow (India )
                2231-0762
                2250-1002
                Nov-Dec 2020
                24 November 2020
                : 10
                : 6
                : 786-793
                Affiliations
                [1 ]Department of Oral Maxillofacial Surgery, Division of Oral Medicine, Al-Farabi College for Nursing and Dentistry, Jeddah, Saudi Arabia
                [2 ]Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
                [3 ]Department of Basic Oral and Clinical Sciences, Division of Oral Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
                Author notes
                Address for correspondence: Dr. Abrar Majed Sabeh, Department of Oral Maxillofacial Surgery, Division of Oral Medicine, Al-Farabi College for Nursing and Dentistry, Jeddah 23311-3062, Saudi Arabia. E-mail: abrarmsabeh@ 123456gmail.com
                Article
                JISPCD-10-786
                10.4103/jispcd.JISPCD_328_20
                7791579
                Copyright: © 2020 Journal of International Society of Preventive and Community Dentistry

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

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