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Similarity of suffering: Equivalence of psychological and psychosocial factors in neuropathic and non-neuropathic orofacial pain patients

Gustin, Sylvia Mariaa,b,*; Wilcox, Sophie L.a; Peck, Chris C.b; Murray, Greg M.b; Henderson, Luke A.a

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doi: 10.1016/j.pain.2010.12.033

The degree to which neuropathic and non-neuropathic pain conditions differ in psychological and psychosocial status remains largely unexplored. A better understanding of these aspects would be of considerable benefit in helping to define whether similar psychological treatment strategies (eg, cognitive-behavioural therapy) can be adopted in the management of neuropathic pain as in non-neuropathic pain conditions. Chronic orofacial pain disorders present a unique opportunity to compare nociceptive and neuropathic pain in the same body region. Twenty-four patients with trigeminal neuropathic pain, 21 patients with temporomandibular disorder, and 38 healthy controls were assessed with a psychological/psychosocial battery encompassing the 4 dimensions of the pain experience; sensory-discriminative, affective-motivational, cognitive-evaluative, and psychosocial. Although patients with trigeminal neuropathic pain (neuropathic pain) and temporomandibular disorder (non-neuropathic pain) described the sensory aspects of their pain differently, they exhibited comparable negative affective-motivational, cognitive-evaluative, and psychosocial states, although these were significantly different compared to healthy controls. These findings support growing evidence that the negative affective, cognitive, and psychosocial state of chronic pain is universal, regardless of a neuropathic or nociceptive nature. Further characterisation of these 4 dimensions of the pain experience in different chronic pain subtypes may improve the efficacy of cognitive-behavioural therapy.

Nociceptive/inflammatory and neuropathic chronic orofacial pain populations report similar affective-motivational, cognitive-evaluative, and psychosocial dimensions of their pain experience but exhibit different sensory-discriminative components.

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

aDepartment of Anatomy & Histology, School of Medical Sciences, University of Sydney, Sydney 2006, Australia

bJaw Function and Orofacial Pain Research Unit, Faculty of Dentistry, Westmead Hospital, University of Sydney, Sydney 2145, Australia

*Corresponding author. Address: Department of Anatomy & Histology, School of Medical Sciences, University of Sydney, Anderson Stuart Building F13, Sydney NSW 2006, Australia. Tel.: +61 2 9351 6878; fax: +61 2 9351 6556.


Submitted July 30, 2010; revised November 5, 2010; accepted December 20, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.
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