Top

Published in:

Open Access 01-12-2016 | Research article

Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement

Authors: Alfonso Gil-Martínez, Mónica Grande-Alonso, Ibai López-de-Uralde-Villanueva, Almudena López-López, Josué Fernández-Carnero, Roy La Touche

Published in: The Journal of Headache and Pain | Issue 1/2015

Abstract

Background

The objective was to compare and correlate disability, pain intensity, the impact of headache on daily life and the fear of movement between subgroups of patients with chronic temporomandibular disorder (TMD).

Methods

A cross-sectional study was conducted in patients diagnosed with chronic painful TMD. Patients were divided into: 1) joint pain (JP); 2) muscle pain (MP); and 3) mixed pain. The following measures were included: Craniomandibular pain and disability (Craniofacial pain and disability inventory), neck disability (Neck Dsiability Index), pain intensity (Visual Analogue Scale), impact of headache (Headache Impact Test 6) and kinesiophobia (Tampa Scale of Kinesiophobia-11).

Results

A total of 154 patients were recruited. The mixed pain group showed significant differences compared with the JP group or MP group in neck disability (p < 0.001, d = 1.99; and p < 0.001, d = 1.17), craniomandibular pain and disability (p < 0.001, d = 1.34; and p < 0.001, d = 0.9, respectively), and impact of headache (p < 0.001, d = 1.91; and p < 0.001, d = 0.91, respectively). In addition, significant differences were observed between JP group and MP group for impact of headache (p < 0.001, d = 1.08). Neck disability was a significant covariate (37 % of variance) of craniomandibular pain and disability for the MP group (β = 0.62; p < 0.001). In the mixed chronic pain group, neck disability (β = 0.40; p < 0.001) and kinesiophobia (β = 0.30; p = 0.03) were significant covariate (33 % of variance) of craniomandibular pain and disability.

Conclusion

Mixed chronic pain patients show greater craniomandibular and neck disability than patients diagnosed with chronic JP or MP. Neck disability predicted the variance of craniofacial pain and disability for patients with MP. Neck disability and kinesiophobia predicted the variance of craniofacial pain and disability for those with chronic mixed pain.

Conti PCR, Pinto-Fiamengui LMS, Cunha CO, Conti ACDCF (2012) Orofacial pain and temporomandibular disorders: the impact on oral health and quality of life. Braz Oral Res 26(Suppl 1):120–123CrossRefPubMed

Benoliel R, Eliav E, Sharav Y (2010) Classification of chronic orofacial pain: applicability of chronic headache criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 110:729–737CrossRefPubMed

National Institutes of Health (1996) Management of temporomandibular disorders. National Institutes of Health Technology Assessment Conference Statement. J Am Dent Assoc 127:1595–1606CrossRef

de Sena MF, de Mesquita KSF, Santos FRR et al (2013) Prevalence of temporomandibular dysfunction in children and adolescents. Rev Paul Pediatr 31:538–545CrossRefPubMedPubMedCentral

Epker J, Gatchel RJ (2000) Coping profile differences in the biopsychosocial functioning of patients with temporomandibular disorder. Psychosom Med 62:69–75CrossRefPubMed

LeResche L (1997) Epidemiology of temporomandibular disorders: implications for the investigation of etiologic factors. Crit Rev Oral Biol Med 8:291–305CrossRefPubMed

Bush FM, Harkins SW, Harrington WG, Price DD (1993) Analysis of gender effects on pain perception and symptom presentation in temporomandibular pain. Pain 53:73–80CrossRefPubMed

Magnusson T, Egermark I, Carlsson GE (2000) A longitudinal epidemiologic study of signs and symptoms of temporomandibular disorders from 15 to 35 years of age. J Orofac Pain 14:310–319PubMed

Suvinen TI, Reade PC, Kemppainen P et al (2005) Review of aetiological concepts of temporomandibular pain disorders: towards a biopsychosocial model for integration of physical disorder factors with psychological and psychosocial illness impact factors. Eur J Pain 9:613–633CrossRefPubMed

10.

Graff-Radford SB (2007) Temporomandibular disorders and headache. Dent Clin N Am 51:129–144CrossRefPubMed

11.

Schiffman EL, Truelove EL, Ohrbach R et al (2010) Assessment of the validity of the research diagnostic criteria for temporomandibular disorders: overview and methodology. J Orofac Pain 24:7–24PubMedPubMedCentral

12.

Gonçalves DAG, Camparis CM, Speciali JG et al (2011) Temporomandibular disorders are differentially associated with headache diagnoses: a controlled study. Clin J Pain 27:611–615CrossRefPubMed

13.

Schiffman EL, Ohrbach R, Truelove EL et al (2010) The research diagnostic criteria for temporomandibular disorders. V: methods used to establish and validate revised axis I diagnostic algorithms. J Orofac Pain 24:63–78PubMedPubMedCentral

14.

Kotiranta U, Suvinen T, Kauko T et al (2015) Subtyping patients with temporomandibular disorders in a primary health care setting on the basis of the research diagnostic criteria for temporomandibular disorders axis II pain-related disability: a step toward tailored treatment planning? J Oral Facial Pain Headache 29:126–134CrossRefPubMed

15.

Silveira A, Gadotti IC, Armijo-Olivo S et al (2015) Jaw dysfunction is associated with neck disability and muscle tenderness in subjects with and without chronic temporomandibular disorders. Biomed Res Int 2015:512792CrossRefPubMedPubMedCentral

16.

Rollman A, Visscher CM, Gorter RC, Naeije M (2012) Care seeking for orofacial pain. J Orofac Pain 26:206–214PubMed

17.

Ciancaglini R, Radaelli G (2001) The relationship between headache and symptoms of temporomandibular disorder in the general population. J Dent 29:93–98CrossRefPubMed

18.

Cairns BE, Sessle BJ, Hu JW (1998) Evidence that excitatory amino acid receptors within the temporomandibular joint region are involved in the reflex activation of the jaw muscles. J Neurosci 18:8056–8064PubMed

19.

Woolf CJ (2011) Central sensitization: implications for the diagnosis and treatment of pain. Pain 152:S2–S15. doi:10.1016/j.pain.2010.09.030.Central CrossRefPubMed

20.

Fernández-de Las Peñas C, Galán-Del Río F, Alonso-Blanco C et al (2010) Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disoders. J Pain 11:1295–1304CrossRefPubMed

21.

Greenspan JD, Slade GD, Bair E et al (2011) Pain sensitivity risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case control study. J Pain 12:1–25CrossRef

22.

Fernández-de las Peñas C, Galán-del Río F, Fernández-Carnero J et al (2009) Bilateral widespread mechanical pain sensitivity in women with myofascial temporomandibular disorder: evidence of impairment in central nociceptive processing. J Pain 10:1170–1178CrossRefPubMed

23.

Staud R (2011) Evidence for shared pain mechanisms in osteoarthritis, low back pain, and fibromyalgia. Curr Rheumatol Rep 13:513–520CrossRefPubMed

24.

Cheung J, Kajaks T, Macdermid JC (2013) The relationship between neck pain and physical activity. Open Orthop J 7:521–529CrossRefPubMedPubMedCentral

25.

Askary-Ashtiani A, Ebrahimi-Takamejani I, Torkaman G, et al (2014) Reliability and validity of the persian versions of the fear avoidance beliefs questionnaire and tampa scale of kinesiophobia in patients with neck pain. Spine (Phila. Pa. 1976). 2014;39(18):E1095–102.

26.

Von Elm E, Altman GD, Egger M, Pocock JS, Gotzsche CPVPJ (2008) Declaración de la Iniciativa STROBE (Strengthening the para la comunicación de estudios observacionales). Gac Sanit 22:144–150CrossRef

27.

Dworkin SF, LeResche L (1992) Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 6:301–355PubMed

28.

La Touche R, Pardo-Montero J, Gil-Martínez A et al (2014) Craniofacial pain and disability inventory (CF-PDI): development and psychometric validation of a new questionnaire. Pain Physician 17:95–108PubMed

29.

Andrade Ortega JA, Delgado Martinez AD, Almecija Ruiz R (2008) Validation of a Spanish version of the neck disability index. Med Clin 130:85–89CrossRef

30.

Jorritsma W, Dijkstra PU, de Vries GE et al (2012) Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index. Eur Spine J 21:2550–2557. doi:10.1007/s00586-012-2407-8 CrossRefPubMedPubMedCentral

31.

Martin M, Blaisdell B, Kwong JW, Bjorner JB (2004) The Short-Form Headache Impact Test (HIT-6) was psychometrically equivalent in nine languages. J Clin Epidemiol 57:1271–1278CrossRefPubMed

32.

Bijur PE, Silver W, Gallagher EJ (2001) Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 8:1153–1157CrossRefPubMed

33.

Gómez-Pérez L, López-Martínez AE, Ruiz-Párraga GT (2011) Psychometric properties of the spanish version of the Tampa scale for kinesiophobia (TSK). J Pain 12:425–435CrossRefPubMed

34.

Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191CrossRefPubMed

35.

Peduzzi P, Concato J, Kemper E et al (1996) A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 49:1373–1379CrossRefPubMed

36.

Mouri H (2013) Log-normal distribution from a process that is not multiplicative but is additive. Phys Rev E 88:42124CrossRef

37.

Nixon RM, Wonderling D, Grieve RD (2010) Non-parametric methods for cost-effectiveness analysis: the central limit theorem and the bootstrap compared. Health Econ 19:316–333CrossRefPubMed

38.

Cohen J (1973) Eta-squared and partial eta-squared in fixed factor ANOVA designs. Educ Psychol Meas 33:107–112CrossRef

39.

Cohen J (1969) Statistical power analysis for the behavioral sciences. Academic, New York

40.

Hinkle D, Jurs S, Wiersma W (1988) Applied statistics for the behavioral sciences, 2nd edn. Houghton Mifflin, Boston

41.

Olivo SA, Fuentes J, Major PW et al (2010) The association between neck disability and jaw disability. J Oral Rehabil 37:670–679CrossRefPubMed

42.

Ozdemir-Karatas M, Peker K, Balık A et al (2013) Identifying potential predictors of pain-related disability in Turkish patients with chronic temporomandibular disorder pain. J Headache Pain 14:17CrossRefPubMedPubMedCentral

43.

Rodrigues JH, Biasotto-Gonzalez DA, Bussadori SK et al (2012) Signs and symptoms of temporomandibular disorders and their impact on psychosocial status in non-patient university student’s population. Physiother Res Int 17:21–28CrossRefPubMed

44.

López-de-Uralde-Villanueva I, Beltran-Alacreu H, Paris-Alemany A et al (2015) Relationships between craniocervical posture and pain-related disability in patients with cervico-craniofacial pain. J Pain Res 30:449–458

45.

Silveira A, Armijo-Olivo S, Gadotti IC, Magee D (2014) Masticatory and cervical muscle tenderness and pain sensitivity in a remote area in subjects with a temporomandibular disorder and neck disability. J Oral Facial Pain Headache 28:138–146CrossRefPubMed

46.

La Touche R, París-Alemany A, Mannheimer JS et al (2013) Does mobilization of the upper cervical spine affect pain sensitivity and autonomic nervous system function in patients with cervico-craniofacial pain?: A randomized-controlled trial. Clin J Pain 29:205–215. doi:10.1097/AJP.0b013e318250f3cd CrossRefPubMed

47.

La Touche R, Fernández-De-Las-Peñas C, Fernández-Carnero J et al (2009) The effects of manual therapy and exercise directed at the cervical spine on pain and pressure pain sensitivity in patients with myofascial temporomandibular disorders. J Oral Rehabil 36:644–652. doi:10.1111/j.1365-2842.2009.01980.x CrossRefPubMed

48.

Souza-e-Silva HR, Rocha-Filho PAS (2011) Headaches and academic performance in university students: a cross-sectional study. Headache 51:1493–1502CrossRefPubMed

49.

Porporatti AL, Costa YM, Conti PCR, et al (2014) Primary headaches interfere with the efficacy of temporomandibular disorders management. J Appl Oral Sci.

50.

LeResche L, Mancl LA, Drangsholt MT et al (2007) Predictors of onset of facial pain and temporomandibular disorders in early adolescence. Pain 129:269–278CrossRefPubMed

51.

Roelofs J, Sluiter JK, Frings-Dresen MHW et al (2007) Fear of movement and (re)injury in chronic musculoskeletal pain: Evidence for an invariant two-factor model of the Tampa Scale for Kinesiophobia across pain diagnoses and Dutch, Swedish, and Canadian samples. Pain 131:181–190CrossRefPubMed

52.

Visscher CM, Ohrbach R, van Wijk AJ et al (2010) The Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK-TMD). Pain 150:492–500CrossRefPubMed

53.

Roelofs J, Goubert L, Peters ML et al (2004) The Tampa Scale for Kinesiophobia: further examination of psychometric properties in patients with chronic low back pain and fibromyalgia. Eur J Pain 8:495–502CrossRefPubMed

54.

Heuts PHTG, Vlaeyen JWS, Roelofs J et al (2004) Pain-related fear and daily functioning in patients with osteoarthritis. Pain 110:228–235CrossRefPubMed

55.

Ohrbach R, Fillingim RB, Mulkey F et al (2011) Clinical findings and pain symptoms as potential risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study. J Pain 12:T27–T45CrossRefPubMedPubMedCentral

56.

Beaton DE, Bombardier C, Guillemin F, Ferraz MB (2000) Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 25:3186–3191CrossRef

Title: Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement
Authors: Alfonso Gil-Martínez
Mónica Grande-Alonso
Ibai López-de-Uralde-Villanueva
Almudena López-López
Josué Fernández-Carnero
Roy La Touche
Publication date: 01-12-2016
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2015
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-016-0690-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Chronic Temporomandibular Disorders: disability, pain intensity and fear of movement

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2015

The efficiency of botulinum toxin type A for the treatment of masseter muscle pain in patients with temporomandibular joint dysfunction and tension-type headache

Alexithymia and psychopathological symptoms in adolescent outpatients and mothers suffering from migraines: a case control study

Side-locked headaches: an algorithm-based approach

Does monosodium glutamate really cause headache? : a systematic review of human studies

Pharmacology of reflex blinks in the rat: a novel model for headache research

Altered kynurenine pathway metabolites in serum of chronic migraine patients