Endogenous Pain Inhibition Deficiency in Chronic TMD Pain

Exclusion Criteria

• •An individual who meets any of the following criteria will be excluded from participation in this study:
• •1. Traumatic facial injury or surgery on the face/jaw, arms, or hands
• •2. Presence of pain related to dental and periodontal pathology
• •3. Pregnant
• •4. Has any of the following medical conditions by self-report:
• •1. Renal failure or dialysis
• •2. Heart disease (examples: uncontrolled arrhythmia or hypertension, cardiomyopathy) or heart failure
• •3. Non-allergic bronchospasm (chronic obstructive pulmonary disease and emphysema)
• •4. Diabetes (type I or II) that is not controlled with medication or diet
• •5. Hyperthyroidism
• •6. Uncontrolled seizures
• •5. Used any injection therapy (e.g., tender or trigger point injections, steroid injections), acupuncture, biofeedback, or TENS for managing facial/jaw pain within 2 weeks before the screening assessment.
• •6. If undergoing botulinum toxin injections in the head and neck area, must be 3 months since the last set of injections, and refrain from this treatment until study participation has ended
• •7. History of major depression or other major psychiatric disorder requiring inpatient hospitalization within the last 6 months before the screening assessment
• •8. History of treatment for drug or alcohol abuse within the last 12 months
• •9. Current pain medication use (e.g., opioids, ibuprofen, acetaminophen) that cannot be stopped \<24 hours before each study visit
• •10. Other conditions/diseases associated with altered pain perception: neurological or development disorders (dementia, autism spectrum disorder), neoplasm, multiple sclerosis, trigeminal neuralgia
• •11. Adults lacking the capacity to provide informed consent for themselves
• •12. Unable to understand instructions for sensory testing in English.
• •13. Thermal threshold for Pain-50 (pre-determined at the beginning of visit 1) is outside the temperature range of 40ºC to 49ºC
• •14. Inability to complete at least four daily ratings between the Informed consent, Pre-visit 1 procedures, and in-person visit 1
• •15. Lack of access to electronic devices with internet connection during the study participation
• •16. Anything that would place the individual at increased risk or preclude the individual's full compliance with study procedures or completion of the study. "