Visual Imagery: A Tool to Explore the Impact of Burning Mouth Syndrome

Aims: To investigate how photographic images (Pain Cards) co-created by an artist and chronic pain patients could be used in groups of patients with burning mouth syndrome to facilitate characterization of their pain and its impact on quality of life. Methods: Ten groups of patients with burning mouth syndrome attending a 2.5-hour information session in a facial pain unit were presented with 54 Pain Cards put in a random order on a table. They were asked to pick one card that described the quality of their pain and one that reflected the impact of the pain on their lives. The total number of patients was 119 (divided into groups of 8 to 14) over a 4-year period. Results: A total of 114 patients chose a Pain Card; 24 cards (chosen a total of 73 times) were used to phenotype the pain and 39 cards (chosen a total of 127 times) were used to describe the impact of the pain. The most frequently used Pain Card (13 times) was a pair of lips closed with a clothes peg, whereas the other most frequently selected images were black and white. The choice of Pain Card and words used to explain the choice implied a neuropathic type of pain. Themes that were common included those of isolation, loss of confidence, low mood, and decrease in activities and socialization. Conclusion: The Pain Cards chosen and the main themes support those found in the literature on BMS. The Pain Cards may help pain sufferers gain more empathy and support due to improved understanding by their health care providers. Keywords: burning mouth syndrome, communication, images, pain