Stress reactivity, but not stressful life events, is associated with treatment selection and clinical outcomes in masticatory myofascial pain patients. A pilot study

Background This study evaluated whether stressful life events (SLE) and stress reactivity (SR) influence treatment selection and outcomes in patients with masticatory myofascial pain (MMFP).Case description Thirty-five patients with MMFP completed the Social Readjustment Rating Scale and the Stress Reactivity Index-32 (IRE-32). Patients received either conventional treatment (cyclobenzaprine plus physiotherapy; n = 15) or the same treatment plus botulinum toxin (BT) infiltration (n = 20). Pain intensity, pressure pain thresholds, and mandibular range of motion were assessed before and after treatment. Results SLE scores did not differ between groups and were unrelated to treatment outcomes. Patients receiving conventional treatment showed higher cognitive, emotional, and global SR scores. In this group, greater SR was associated with poorer improvements in pain and mandibular function, whereas no such associations were observed in the BT group.Conclusions SR, rather than SLE, may be a clinically relevant predictor of treatment selection and response in patients with masticatory myofascial pain.Practical implications Assessing SR may support personalized treatment decisions.