Craniomandibular muscles, intraoral orthoses and migraine

Intraoral splints are effective in migraine prevention. In this review, changes in the quality of life of migraineurs treated with a palatal nonoccluding splint were measured. Using the Migraine Specific Quality of Life Instrument (Version 2.1), it was found that the palatal nonoccluding splint significantly improved the quality of life of migraineurs. The role of the craniomandibular muscles in the pathophysiology of migraine is also discussed.

Headache and other types of chronic pain

OBJECTIVE

To compare pain severity, disability, psychological distress, and quality of life between patients with headache and nonheadache treatment-seeking chronic pain patients.

METHODS

Six hundred forty-three patients seeking treatment at a university pain clinic were divided into 3 categories based on primary pain complaint and the presence of focal or diffuse pain complaints: headache, nonheadache focal (pain involving <50% of the body), and nonheadache diffuse (pain involving >/=50% of the body). Patients completed questionnaires to identify pain severity, disability, depression, anxiety, and quality of life.

RESULTS

Patients with headache differed from nonheadache patients for all evaluated parameters. Average pain severity on a 0 to 10 point severity scale was 5.55 for headache, 6.93 for nonheadache focal, and 8.05 for nonheadache diffuse. Pain occurred an additional 1.51 to 1.71 days per week for patients without headache. Compared to patients with headache, patients without headache reported greater frequency of reduced daily activities and complete disability related to pain. In addition, patients without headache and with diffuse pain reported more depression (78.2% vs. 45.8%) and anxiety (70.0% vs. 39.1%) than patients with headache. Quality of life measures were significantly reduced in patients with either nonheadache focal or diffuse conditions compared to patients with headache.

CONCLUSIONS

Even when considering patients with focal rather than diffuse chronic pain complaints, patients with headache are dissimilar from other patients with chronic pain. Pain severity, frequency, disability, psychological distress, and quality of life are significantly more prominent or impaired in patients with chronic pain without headache compared to patients with headache.