The impact of gender of the examiner on orofacial pain perception and pain reporting among healthy volunteers.

OBJECTIVES: Pain on palpation of jaw muscles is a commonly used diagnostic criterion when examining patients with orofacial pain. It is not known, however, if pain reports are affected by the gender of the examiner. Our aim was to investigate if pressure pain threshold (PPT), pressure pain tolerance (PTol), and pain intensity assessed over the masseter muscles in healthy individuals are affected by the gender of the examiner. MATERIALS AND METHODS: Healthy, pain-free individuals were recruited on a voluntary basis. PPT and PTol were assessed using pressure algometry. At the PTol level, participants also rated pain intensity on a 0-10 numeric rating scale. Assessments of PPT and PTol were conducted with six repeated measurements performed twice, separately by one female and one male examiner, on each participant. RESULTS: In total, 84 participants (43 women; median age 24, IQR 6) were included. With a female examiner, women reported higher pain intensity than men (Mann Whitney U, p = 0.005). In the multivariable analysis, significantly higher PTol was predicted by male examiner. Also, a higher ratio between PTol and reported pain intensity was predicted by male examiner. CONCLUSIONS: The gender of the examiner influences pain reporting and perception in an experimental setting. This effect on pain perception related to gender of the examiner is probably related to normative gender behaviors rather than to biological alterations within the examined individual. CLINICAL RELEVANCE: In clinical and experimental settings, gender of the examiner may affect not only pain perception but also pain reporting, with potential implications for diagnostics in patients with pain.

Musculoskeletal discomfort of music teachers: an eight-year perspective and psychosocial work factors.

Musicians at all levels of performance, especially string players, are known to have a high prevalence of work-related musculoskeletal disorders. The disorders seem to be most common in the neck, shoulders and low back. In 1988, a survey of the work-related musculoskeletal disorders of 36 music teachers was carried out at a music school in northern Sweden. In 1996, the teachers were reinvestigated. The study also included an investigation of the psychosocial work environment according to the Karasek demand-control theory, as well as measurements of upper-arm elevation during a working day in five violin teachers. The results showed that music teachers, like other professional musicians, often experience discomfort in the neck, shoulders, and low back. The discomfort tended to be of long duration, increasing over the years. The psychosocial work environment was characterized by high psychological demands and low authority over decisions. This was compensated for through good social support. The work required skill and creativity but was monotonous. The measurements of upper-arm elevation indicated considerable variations in shoulder positions between teachers. There were also differences in the work done with the right and left arms, with repetitive motions more commonly involving the right arm. Approximately a fourth of the working day was spent with the arm elevated 30-90 degrees. The relationships between upper-arm movements and ratings of discomfort were moderate.