Central Sensitisation, Anxiety and Depressive Symptoms in Patients With Chronic Masticatory Muscle Pain

Chronic masticatory muscle pain (CMMP), a common symptom of temporomandibular disorders (TMD), is influenced by numerous factors. Central sensitisation (CS) is a significant factor in both chronic pain and temporomandibular disorders. Psychological aspects like anxiety and depression are known to exacerbate pain symptoms. However, the interplay between CS and these factors in CMMP remains unclear.

The objective of this study was to evaluate the relationship between CS, anxiety and depressive symptoms in patients with CMMP and to assess how they correlate.

A total of 206 patients with CMMP underwent a clinical examination following the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and completed the Central Sensitisation Inventory (CSI), Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7) questionnaires. Pain severity was assessed using the Graded Chronic Pain Scale (GCPS) and the Numeric Rating Scale (NRS). Statistical analyses were conducted to examine correlations and group differences.

Significant correlations were found between CSI and both PHQ-9 (r_s = 0.719, p < 0.001) and GAD-7 (r_s = 0.203, p = 0.003). A higher CSI score correlated with greater intensity of masticatory muscle pain. Women reported significantly higher scores for CS, anxiety and depression than men.

This study highlights a significant relationship between CS, anxiety, depressive symptoms and masticatory muscle pain. These findings underscore the importance of addressing psychological factors and central nervous system dysfunction in managing CMMP to enhance patient outcomes.