Referred Pain Manifestation and Its Impact on Patients With Temporomandibular Disorder

Abstract

Objective: To investigate whether a higher number of sites eliciting referred pain upon palpation is associated with greater impairment in biopsychosocial aspects in TMD patients and identify variables that predict increased referred pain. Methods: This cross-sectional study analyzed data from 77 women with myalgia, assessing the number of sites eliciting referred pain upon palpation in relation to clinical (duration, frequency, intensity, painful body sites, pain-related disability), psychological (stress, anxiety, depression, catastrophizing, sleep quality), and psychophysical variables (mechanical and pressure pain thresholds, temporal summation and conditioned pain modulation). Results: Spearman's correlation revealed a significant correlation between the number of sites eliciting referred pain upon palpation in the orofacial region and both pain intensity and frequency (p < 0.001), as well as with the number of painful body sites (p = 0.009). Negative binomial regression indicated that each additional day of pain in the past week and each additional painful body site were predictors of increases of 10% and 4%, respectively, in the number of sites eliciting referred pain upon palpation. Conclusions: These findings highlight the utility of assessing referred pain sites as a complementary indicator of severity in clinical pain parameters, providing a practical and effective tool for a more comprehensive evaluation of patients.