Plesh Octavia, Adams Sally H, Gansky Stuart A
Departmetn of Preventive and Restorative Dental Sceinces, University of California, San Francsco, CA 94143-0758, USA.
J Orofac Pain. 2011 Summer;25(3):190-8.
To compare prevalences of self-reported comorbid headache, neck, back, and joint pains in respondents with temporomandibular joint and muscle disorder (TMJMD)-type pain in the 2000-2005 US National Health Interview Survey (NHIS), and to analyze these self-reported pains by gender and age for Non-Hispanic (NH) Whites (Caucasians), Hispanics, and NH Blacks (African Americans).
Data from the 2000-2005 NHIS included information on gender, age, race, ethnicity, education, different common types of pain (specifically TMJMD-type, severe headache/migraine, neck, and low back pains), changes in health status, and health care utilization. Estimates and test statistics (ie, Pearson correlations, regressions, and logistic models) were conducted using SAS survey analysis and SUDAAN software that take into account the complex sample design.
A total of 189,977 people (52% female and 48% males, 73% NH Whites, 12% Hispanic, 11% NH Blacks, and 4% "Other") were included. A total of 4.6% reported TMJMD-type pain, and only 0.77% overall reported it without any comorbid headache/migraine, neck, or low back pains; also 59% of the TMJMD-type pain (n = 8,964) reported ⋝ two comorbid pains. Females reported more comorbid pain than males (odds ratio [OR] = 1.41, P < .001); Hispanic and NH Blacks reported more than NH Whites (OR = 1.56, P <.001; OR= 1.38, P <.001, respectively). In addition, 53% of those with TMJMD-type pain had severe headache/migraines, 54% had neck pain, 64% low back pain, and 62% joint pain. Differences in gender and race by age patterns were detected. For females, headache/migraine pain with TMJMD-type pain peaked around age 40 and decreased thereafter regardless of race/ethnicity. Neck pain continued to increase up to about age 60, with a higher prevalence for Hispanic women at younger ages, and more pronounced in males, being the highest in the non-Whites. Low back pain was higher in Black and Hispanic females across the age span, and higher among non-White males after age 60. Joint pain demonstrated similar patterns by race/ethnicity, with higher rates for Black females, and increased with age regardless of gender.
TMJMD-type pain was most often associated with other common pains, and seldom existed alone. Two or more comorbid pains were common. Gender, race, and age patterns for pains with TMJMD-type pain resembled the specific underlying comorbid pain.
在2000 - 2005年美国国家健康访谈调查（NHIS）中，比较颞下颌关节和肌肉紊乱（TMJMD）型疼痛受访者中自我报告的合并头痛、颈部、背部和关节疼痛的患病率，并按性别和年龄对非西班牙裔（NH）白人（高加索人）、西班牙裔和NH黑人（非裔美国人）的这些自我报告疼痛进行分析。
2000 - 2005年NHIS的数据包括性别、年龄、种族、民族、教育程度、不同常见疼痛类型（特别是TMJMD型、严重头痛/偏头痛、颈部和下背部疼痛）、健康状况变化以及医疗保健利用情况。使用考虑复杂样本设计的SAS调查分析和SUDAAN软件进行估计和检验统计（即Pearson相关性、回归和逻辑模型）。
共纳入189,977人（52%为女性，48%为男性，73%为NH白人，12%为西班牙裔，11%为NH黑人，4%为“其他”）。共有4.6%的人报告有TMJMD型疼痛，总体上只有0.77%的人报告有该疼痛且无任何合并头痛/偏头痛、颈部或下背部疼痛；TMJMD型疼痛者中也有59%（n = 8,964）报告有两种及以上合并疼痛。女性报告的合并疼痛多于男性（优势比[OR] = 1.41，P <.001）；西班牙裔和NH黑人报告的合并疼痛多于NH白人（分别为OR = 1.56，P <.001；OR = 1.38，P <.001）。此外，53%的TMJMD型疼痛患者有严重头痛/偏头痛，54%有颈部疼痛，64%有下背部疼痛，62%有关节疼痛。检测到按年龄模式划分的性别和种族差异。对于女性，无论种族/民族，TMJMD型疼痛伴发的头痛/偏头痛疼痛在40岁左右达到峰值，此后下降。颈部疼痛持续增加至约60岁，西班牙裔女性在较年轻时患病率较高，男性更为明显，非白人中最高。黑人及西班牙裔女性在各年龄段下背部疼痛患病率较高，60岁后非白人男性中患病率更高。关节疼痛按种族/民族呈现相似模式，黑人女性患病率较高，且无论性别均随年龄增加。
TMJMD型疼痛最常与其他常见疼痛相关，很少单独存在。两种或更多合并疼痛很常见。TMJMD型疼痛伴发的疼痛在性别、种族和年龄模式上与特定的潜在合并疼痛相似。
