The Role of Pain Inflexibility and Acceptance among Headache and Temporomandibular Disorders Patients

Int J Environ Res Public Health. 2022 Jun 29;19(13):7974. doi: 10.3390/ijerph19137974.

Abstract

Temporomandibular disorders (TMD) and headache are complex. This study aims to assess the association between TMD, headache, and psychological dimensions such as psychological inflexibility and pain acceptance. The sample consisted of 120 participants following a non-probabilistic convenience sampling strategy through a direct invitation to the patients attending our facilities and their relatives (n = 61 diagnosed with headache, n = 34 diagnosed with TMD-headache, n = 25 control group). Diagnostic Criteria for Temporomandibular Disorders (DC-TMD), International Classification of Headache Disorders (ICHD-3 beta version), Chronic Pain Acceptance Questionnaire (CPAQ-8), and Psychological Inflexibility in Pain Scale (PIPS) were used as assessment tools. One-way ANOVA, multiple regression analysis (MRA), and the Johnson-Neyman approach were run by IBM SPSS, version 27 (IBM® Company, Chicago, IL, USA). The significance level was 0.05. One third of our sample presented with headache with TMD. Females were predominant. Males with headache, no systemic disease, less pain severity but higher frequency, living longer with the disease and having sensitive changes, showed higher pain acceptance. When headache occurs with TMD, women with higher education, no headache family history, less pain, and no motor changes showed higher pain acceptance. Patients with both conditions are more liable to have chronic pain and pain inflexibility. Pain intensity and willingness explain 50% of the psychological inflexibility in the headache group. In our sample, individuals suffering from both conditions show greater pain inflexibility, implicating more vivid suffering experiences, leading to altered daily decisions and actions. However, further studies are needed to highlight this possible association.

Keywords: Temporomandibular joint syndrome; chronic pain; headache; pain acceptance pain inflexibility; psychosocial variables.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Pain*
  • Facial Pain
  • Female
  • Headache / epidemiology
  • Headache / etiology
  • Humans
  • Male
  • Pain Measurement
  • Surveys and Questionnaires
  • Temporomandibular Joint Disorders* / complications
  • Temporomandibular Joint Disorders* / epidemiology

Grants and funding

This work was financed by FEDER—Fundo Europeu de Desenvolvimento Regional funds through the COMPETE 2020—Operacional Programme for Competitiveness and Internationalisation (POCI), Portugal 2020, and by Portuguese funds through FCT—Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior in the framework of the project PTDC/MEC-NEU/29486/2017 (POCI-01-0145-FEDER-029486). Also, through the grant SFRH/BD/09375/2020 and in the scope of the projects UIDB/04436/2020, UIDP/04436/2020 and as well as by ‘European Commission’ and ‘European Regional Development Fund’ under the project ‘Análisis y correlación entre la epigenética y la actividad cerebral para evaluar el riesgo de migraña crónica y episódica en mujeres’ (‘Cooperation Programme Interreg V-A Spain-Portugal POCTEP 2014–2020’). This work was also supported by UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal, in the scope of OrthoAlign-PI-4RL-IINFACTS-2019.