Dao T T, Reynolds W J, Tenenbaum H C
Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Mount Sinai Hospital, Ontario, Canada.
J Orofac Pain. 1997 Summer;11(3):232-41.
This study compared myofascial pain of the masticatory muscles to fibromyalgia. Study data show that, in both myofascial pain and fibromyalgia patients, facial pain intensity and its daily pattern and effect on quality of life are very similar. This indicates that fibromyalgia should be included in the differential diagnosis for myofascial pain of the masticatory muscles. However, with the higher prevalence of neurologic and gastrointestinal symptoms, and the stronger words used to describe the affective dimension of pain, it is apparent that fibromyalgia may be a more debilitating condition than myofascial pain of the masticatory muscles. Since the intensity of facial pain was strongly and significantly correlated to the body-pain index in fibromyalgia but not in myofascial pain patients, it can be concluded that facial pain may be part of the clinical manifestations of fibromyalgia, but it is unlikely to be related to body pain in myofascial pain patients. On the other hand, while body pain is episodic in most myofascial pain patients, it is constant and more severe in the majority of fibromyalgia patients. This difference in the pain patterns suggests that body pain in fibromyalgia and myofascial pain could have different etiologies. The lack of correlation between the intensity of pain and the length of time since onset also supports the concept that myofascial pain of the masticatory muscles and fibromyalgia are unlikely to be progressive disorders.
本研究比较了咀嚼肌肌筋膜疼痛与纤维肌痛。研究数据表明，在肌筋膜疼痛患者和纤维肌痛患者中，面部疼痛强度及其日常模式以及对生活质量的影响非常相似。这表明纤维肌痛应纳入咀嚼肌肌筋膜疼痛的鉴别诊断中。然而，由于神经和胃肠道症状的患病率较高，以及用于描述疼痛情感维度的词汇更强，显然纤维肌痛可能比咀嚼肌肌筋膜疼痛更使人衰弱。由于纤维肌痛患者的面部疼痛强度与身体疼痛指数强烈且显著相关，而肌筋膜疼痛患者则不然，因此可以得出结论，面部疼痛可能是纤维肌痛临床表现的一部分，但不太可能与肌筋膜疼痛患者的身体疼痛有关。另一方面，虽然大多数肌筋膜疼痛患者的身体疼痛是发作性的，但大多数纤维肌痛患者的身体疼痛是持续的且更严重。这种疼痛模式的差异表明，纤维肌痛和肌筋膜疼痛中的身体疼痛可能有不同的病因。疼痛强度与发病时间长短之间缺乏相关性也支持了咀嚼肌肌筋膜疼痛和纤维肌痛不太可能是进行性疾病的观点。
