Look carefully; a short note on symptom substitution

Myofascial pain-dysfunction syndrome: a psychobiological perspective

Myofascial pain-dysfunction (MPD) syndrome is a muscle-contraction headache-like pain of the face. In the past this has also been called temporomandibular joint syndrome. This syndrome is thought to be, in part, a stress-related pain. This paper discusses and evaluates the following topics: (1) patient characteristics, (2) etiological hypotheses, (3) experimental models of the syndrome, (4) psychological characteristics of the patients, (5) psychophysiological characteristics of the patients, and (6) relaxation therapies. Future research is also discussed.

Long-term prognosis of behavior therapy in practice

A prognosis study was carried out on 30 cases of patients treated with behavior therapy. The treatments, which took more than three years before the study, averaged four years and eight months. The results are as follows: (1) The improvement achieved by therapy was maintained or further improved in 29 cases during the post-therapeutic period of more than three years. (2) The prognosis largely depended on the grade of improvement at the end of therapy. A complete disappearance of symptoms at the end of therapy did not necessarily mean that it was a fair prognosis. (3) There was no relation between the prognosis and the length of history of illness or the situation of therapy terminated. (4) The impression is that long-term prognoses are different depending on the main symptoms.

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.

Myofascial pain of the temporomandibular joint: a review of the behavioral-relaxation therapies

This paper reviews the behavioral-relaxation treatments of myofascial pain-dysfunction syndrome. The evidence indicates that this pain (located around the oral cavity) is due to muscle hyperactivity, most commonly of the lateral pterygoids. Research concerning relaxation techniques (i.e. progressive muscle relaxation and electromyographic feedback) has indicated the following: (a) in analogue research, normal healthy controls can learn to relax their muscles of mastication profoundly even during stress, and (b) in case reports, relaxation treatments are helpful clinical interventions, especially for pain patients who are not depressed, and who have not had the pain for more than a few years. Well controlled research is the next, essential step.