Changes in function and in pain-related and cognitive-behavioral variables after arthroscopy of temporomandibular...

The purpose was to prospectively evaluate changes in clinical, pain, and cognitive-behavioral variables in a structurally homogenous group of patients with painful temporomandibular joints (TMJ), who had undergone an identical intervention, arthroscopy. Twenty-six consecutive patients who had previously undergone unsuccessful conservative treatment participated. They were evaluated with the Craniomandibular Index (CMI), pain-related measures on visual analogue scales (VASs) for 1 wk, questionnaires, and the Multidimensional Pain Inventory (MPI). The mean CMI decreased significantly, from 0.28 to 0.18, 3 months after surgery. Pain measures also decreased significantly as rated on questionnaires, and "at worst" and "most of the time" on VASs. Intrapsychic variables related to pain also decreased significantly, while interpersonal and activity measures remained unchanged. An overall MPI dysfunctional variable correlated significantly with pain. Few further changes were observed at 12 months. Lysis and lavage of the upper TMJ compartment appears to effectively alleviate persisting functional and pain-related symptoms with low morbidity, in line with previous findings. Recoveries seem to be accompanied by changes in certain pain-related cognitive-behavioral variables within a limited sphere. Biological and intrapsychic features may interact with interpersonal factors in a complicated way in patients with orofacial pain.