Cryptotrauma

Abstract

In the treatment of chronic pain, the incidence of physical, emotional, and sexual abuse often remain undiagnosed.In a recent study, Domino and Haber (1987) reported that 66% of women presenting to a multidisciplinary pain center with chronic headaches had a prior history of physical and/or sexual abuse. We report two facial pain patients that had undergone surgery for recurring temporomandibular joint disorders, but were still suffering from frequent headaches, muscle pain, bruxism, and limited jaw opening. Feelings of depression and helplessness were also present. After undergoing physical therapy with minimal improvement, both patients were referred by the oral and maxillofacial surgeon for biofeedback and strees management to help alleviate their symptoms. After treating the patients for several sessions with no improvement, both revealed that the origin of their pain problem involved physical abuse from within the family system. In both cases the incident had been hidden from the medical doctor and dentists for over 8 years. When the patients were able to discuss the traumatic events and process feelings associated with the incident, significant reductions in headache symptoms, muscle tension levels, bruxism, and depressive mood states were reported.