Changes in function and in pain-related and cognitive-behavioral variablesafter arthroscopy of temporomandibular joints

The purpose was to prospectively evaluate changes in clinical, pain. and co gnitive-behavioral variables in a structurally homogenous group of patients with painful temporomandibular joints (TMJ), who had undergone an identica l intervention, arthroscopy. Twenty-six consecutive patients who had previo usly undergone unsuccessful conservative treatment participated. They were evaluated with the Craniomandibular Index (CMI), pain-related measures on v isual analogue scales (VASs) for 1 wk. questionnaires, and the Multidimensi onal 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 dys functional 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 sym ptoms with low morbidity, in line with previous findings. Recoveries seem t o be accompanied by changes in certain pain-related cognitive-behavioral va riables within a Limited sphere. Biological and intrapsychic features may i nteract with interpersonal factors in a complicated way in patients with or ofacial pain.