Relationship between pain sensitivity and resting arterial blood pressure in patients with painful temporomandibular disorders

William Maixner, Roger Fillingim, Shelley Kincaid, Asgeir Sigurdsson, M. Brennan Harris

Research output: Contribution to journalArticle

Abstract

Objective: Patients experiencing temporomandibular disorders (TMD) show greater sensitivity to painful stimuli than age- and gender-matched control subjects. This enhanced pain sensitivity may result, at least in part, from an alteration in pain regulatory systems that are influenced by resting arterial blood pressure. In this study, we examined the relationship between resting systolic blood pressure and pain perception in 64 female TMD and 23 age-matched pain-free female subjects. Method: Resting arterial blood pressure and measures of thermal and ischemic pain threshold and tolerance were determined for each participant. Subjective ratings of thermal pain evoked by suprathreshold noxious thermal stimuli (45-49°C) using a magnitude matching procedure were also obtained for both groups. Results: TMD patients had lower thermal and ischemic pain thresholds and tolerances than pain-free subjects (ps<.05). Both groups provided equivalent intensity ratings to suprathreshold noxious thermal stimuli. A median split of each group based on resting systotic blood pressure revealed an influence of blood pressure on both thermal and ischemic pain perception for the Pain-Free group. The Pain- Free high resting blood pressure subgroup had higher thermal pain tolerances, higher ischemic pain thresholds, and provided lower magnitude estimates of the intensity of graded heat pulses compared with the Pain-Free low blood pressure subgroup. A trend toward a significant effect of blood pressure level on ischemic pain tolerance was also observed for the Pain-Free group. In contrast to the Pain-Free group, blood pressure level did not influence ischemic or thermal pain perception for TMD patients. Similar to the lack of effect of resting blood pressure on experimental pain perception in TMD patients, resting blood pressure was not related to measures of clinical orofacial pain in TMD patients. Conclusions: These findings confirm our previous findings that TMD patients are more sensitive to noxious stimuli and suggest that painful TMD may result, at least in part, from an impairment in central pain regulatory systems that are influenced by resting arterial blood pressure.

Original languageEnglish (US)
Pages (from-to)503-511
Number of pages9
JournalPsychosomatic Medicine
Volume59
Issue number5
DOIs
StatePublished - Jan 1 1997

Keywords

  • Blood pressure
  • Pain regulatory systems
  • Pain sensitivity
  • Temporomandibular disorders

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

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