Dr. Greenspan and Colleague Test a Patient's TMJ Pain Threshold
Tomorrow at the American Pain Society annual meeting, scientists from University of Maryland Dental School and three other universities will be reporting on the first results from their OPPERA study.
The OPPERA study is the largest study so far about TMJ disorder and jaw pain.
Over 3,000 people will be studied for seven years, hoping to figure out what causes TMJD, the effects it has on patients, and hopefully some new treatments. Joel Greenspan, PhD, MS, who is a professor at the dental school, says that even though many TMJ patients do get better in a short time, some actually get worse, and for many with TMJD, it can take years to feel relief.
As patients ourselves, we know those things…. but they will be presenting two new items from the research that no one has been able to say with absolute certainty… until now.
Number One: it seems as though TMJ disorder patients have a “generalized pain sensitivity” that is higher than other people. Meaning, that the way the pain signals are processed in the brains of TMJ patients is different. Not just different… but amplified and intensified. The scientists believe that people with TMJ pain may be more sensitive to pain because of this. This is what the researchers are calling “chronic sensory disorder.” The scientists also find that chronic fatigue syndrome, IBS, fibromyalgia are sensory disorders, too. These conditions share the same pain sensitivity issues that TMJD patients have.
Number Two: TMJD patients seem to be struggling with a high number of other chronic pain conditions at the same time, more chronic pain conditions than people without jaw problems.
There have, of course, been other studies that have come up with some of the same conclusions. However, what makes this study different is the large amount of data the researchers are getting from the participants. Along with information about their jaw pain, the patients are also talking with scientists about topics like their demographics, genetic variations, behavior habits, psychological information, and their body’s physiology. Hopefully, all of this information will help scientists deduce information about causes, effects, and future medications or treatments for TMJ disorder.
There was a time when I wouldn’t have considered this study to be enough or to even be worthy of blogging about. However, as I was writing this, I realized:
This is the first time in all the years of my advocacy career that I have been able to cover a study that legitimately researches the basics of TMJ disorder! Basics that we desperately need, like what is TMJ… who gets it? what causes it?
This research gives me hope.
What do you think?
Looked into OPPERA study. Curious to see how many in TMJHope have tried Inderal (Propanolol) for pain?
(NIH Pain Consortium May 2009): “The LPS allele produces a more active form of COMT and reduced levels of catecholamine neurotransmitters. This fact raises the possibility that treatment with drugs that block catecholamine receptors could reduce chronic pain. To test this idea, patients with chronic TMJ pain were treated with a low dose of the beta-blocker propranolol. (A beta-blocker is a drug that blocks catecholamine receptors of the beta-adrenergic type.) Interestingly, treatment results depended on how many copies of the LPS allele patients carried: substantial improvement was seen in patients who did not carry the allele, whereas little or no improvement was seen in those with two copies of it. Thus, there may be subgroups of chronic pain patients for whom beta-blockers will be effective therapeutics”.
“The scientists believe that people with TMJ pain may be more sensitive to pain because of this. This is what the researchers are calling ‘chronic sensory disorder.'”
Hmmmm…I don’t think this applies to me. I almost never use aspirin or other pain killers (though I really don’t get headaches very often, either) and never used Ibuprofen in my life before I was diagnosed with TMJ. I do use anesthesia when I visit the dentist. (In fact, I suspect that may be a contributing factor in my TMJ.)
Overall, I’ve always considered myself highly pain tolerant. But I’ve only had TMJ for about a week and am still learning the ropes. So far, my condition isn’t extremely painful. I’m taking three or four Ibuprofen pills a day, and that manages the pain pretty well – though my lower left jaw is still sore to the touch.
I certainly don’t have a chronic sleep disorder. I have an extremely strenuous job working night shift for UPS and worry more about getting enough sleep than not being able to sleep. I typically take frequent naps on weekends, in an effort to catch up.
This is an interesting, and obviously important, study, though.
Rhody, I have heard of people taking Propanolol for migraines, but not for TMJ disorder.
David, I have also felt the same way, that I have a high pain tolerance. I wonder if in some people, it is not so much about tolerance, but more about the fact that your body is more sensitive to having TMJD pain. It will be very interesting to see what happens with this study.