Perceived helpfulness of treatments for myofascial TMD as a function of comorbid widespread pain
- 45 Downloads
This study examined whether patients with myofascial temporomandibular disorder (mTMD) comorbid with fibromyalgia (FM) receive different treatments or respond differently to these treatments than mTMD-only patients.
Materials and methods
A total of 125 mTMD+ women were enrolled (26 FM+ and 98 FM−). mTMD and FM were assessed via clinical research examinations. Treatment histories and self-reported treatment-related improvement were obtained via interview.
The top 3 most common treatments reported were oral appliances (59%), physical therapy (54%), and jaw exercises at home (34%). Use of alternative medicine was reported more frequently among FM+ women, but self-reported improvement did not differ by comorbid FM. Physical therapy was as likely reported by FM status but self-reported improvement scores trended higher for FM+ women.
Oral appliances were as likely to be reported by FM comorbid as FM− women. Oral appliances did not outperform self-management treatments on self-reported improvement of facial pain.
Results support the use of self-management as first-line treatment for mTMD and potential utility of inquiring about widespread pain for treatment planning.
KeywordsTemporomandibular disorders Fibromyalgia Widespread pain Facial pain Self-reported improvement
This work was supported in part by the National Institutes of Health under grants R01DE018569 and R01DE024522-01S1.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This project underwent full ethics review and approval by the New York University School of Medicine Institutional Review Board (IRB#07-303).
All subjects underwent and signed a full informed consent procedure before enrollment.
- 1.NIH (2017) Facial pain. National Institutes of Dental and Craniofacial Research and Office of Research on Women’s Health. http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/FacialPain. Accessed 14 June 2017
- 2.Lobbezoo F, Drangsholt M, Peck C, Sato H, Kopp S, Svensson P (2004) Topical review: new insights into the pathology and diagnosis of disorders of the temporomandibular joint. J Orofac Pain 18:181–191Google Scholar
- 6.Velly AM, Look JO, Schiffman E, Lenton PA, Kang W, Messner RP, Holcroft CA, Fricton JR (2010) The effect of fibromyalgia and widespread pain on the clinically significant temporomandibular muscle and joint pain disorders--a prospective 18-month cohort study. J Pain 11:1155–1164. https://doi.org/10.1016/j.jpain.2010.02.009 CrossRefGoogle Scholar
- 9.Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Michael Franklin C, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, Mccain GA, John Reynolds W, Romano TJ, Jon Russell I, Sheon RP (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheumatol 33:160–172CrossRefGoogle Scholar
- 10.Balasubramaniam R, de Leeuw R, Zhu H, Nickerson RB, Okeson JP, Carlson CR (2007) Prevalence of temporomandibular disorders in fibromyalgia and failed back syndrome patients: a blinded prospective comparison study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 104:204–216. https://doi.org/10.1016/j.tripleo.2007.01.012 CrossRefGoogle Scholar
- 11.Plesh O, Wolfe F, Lane N (1996) The relationship between fibromyalgia and temporomandibular disorders: prevalence and symptom severity. J Rheumatol 23:1948–1952Google Scholar
- 13.Fraga BP, Santos EB, Farias Neto JP, Macieira JC, Quintans LJJ, Onofre ASC, De Santana JM, Martins-Filho PRS, Bonjardim LR (2012) Signs and symptoms of temporomandibular dysfunction in fibromyalgic patients. J Craniofac Surg 23:615–618. https://doi.org/10.1097/scs.0b013e31824cd81a CrossRefGoogle Scholar
- 14.Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, List T, Svensson P, Gonzalez Y, Lobbezoo F, Michelotti A, Brooks SL, Ceusters W, Drangsholt M, Ettlin D, Gaul C, Goldberg LJ, Haythornthwaite JA, Hollender L, Jensen R, John MT, De Laat A, de Leeuw R, Maixner W, van der Meulen M, Murray GM, Nixdorf DR, Palla S, Petersson A, Pionchon P, Smith B, Visscher CM, Zakrzewska J, Dworkin SF (2014) Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group. J Orofac Pain 28:6–27. https://doi.org/10.11607/jop.1151 Google Scholar
- 15.Al-Ani MZ, Davies Stephen J, Gray Robin JM, Sloan P, Glenny A-M (2009) Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD002778.pub3
- 16.NIH (2013) Temporomandibular joint and muscle disorders. National Institiute of Dental and Craniofacial Research and Office of Research on Women’s Health. http://www.nidcr.nih.gov/oralhealth/Topics/TMJ/TMJDisorders.htm. Accessed 18 April 2017
- 20.Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6:301–355Google Scholar
- 24.Derogatis LR (1983) SCL-90-R: administration, Scoring and procedures manual--II for the revised version. Clinical Psychometric Research, BaltimoreGoogle Scholar
- 25.StataCorp (2015) Stata Statistical Software: Release 14. StataCorp LP, College StationGoogle Scholar
- 31.Calixtre LB, Moreira RF, Franchini GH, Alburquerque-Sendin F, Oliveira AB (2015) Manual therapy for the management of pain and limited range of motion in subjects with signs and symptoms of temporomandibular disorder: a systematic review of randomised controlled trials. J Oral Rehabil 42:847–861. https://doi.org/10.1111/joor.12321 CrossRefGoogle Scholar
- 33.Cho SH, Whang WW (2010) Acupuncture for temporomandibular disorders: a systematic review. J Orofac Pain 24:152–162Google Scholar
- 36.DeBar LL, Vuckovic N, Schneider J, Ritenbaugh C (2003) Use of complementary and alternative medicine for temporomandibular disorders. J Orofac Pain 17:224–236Google Scholar