Dahan Haissam, Shir Yoram, Velly Ana, Allison Paul
Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, H3A 1G1, Canada,
J Headache Pain. 2015;16:528. doi: 10.1186/s10194-015-0528-2. Epub 2015 May 20.
Temporomandibular pain disorder (TMD) is a common pain condition in the face. People with TMD report multiple pain comorbidities. The presence of fibromyalgia and migraine in people with TMD is associated with an increase in TMD pain intensity and duration. However, data on the relationship between increasing number of pain comorbidities and TMD pain are rare. The aims of this study were: firstly to evaluate the extent to which increasing number of comorbidities is associated with increasing TMD pain intensity and duration; and secondly to evaluate the extent to which the presence of specific comorbidities is associated with increasing TMD pain intensity and duration.
The sample included 180 people seeking TMD treatment at Boston and Montreal clinics. TMD was diagnosed using the Research Diagnostic Criteria for TMD. A Numerical Pain Rating Scale assessed TMD pain intensity and participants provided their TMD pain duration in a study questionnaire. The comorbidities of migraine, chronic fatigue syndrome, irritable bowel syndrome, interstitial cystitis and restless leg syndrome were diagnosed by 5 validated diagnostic questionnaires. The associations were analyzed by linear regression, controlling for confounders.
There was a positive association between the number of comorbidities present and TMD pain intensity (p < 0.01) and between the number of comorbidities present and TMD pain duration (p < 0.01). Also, the presence of migraine was positively associated with TMD pain intensity (p < 0.01) and the presence of chronic fatigue syndrome was positively associated with TMD pain intensity (p < 0.05) and with TMD pain duration (p < 0.01). When TMD patients were separated into groups, these associations did not change for the myofascial pain group, whereas in the non-myofascial pain group, the relationship between number of comorbidities and TMD pain duration was the only one still present.
This study shows that the number of comorbidities is positively associated with TMD pain duration and intensity. The presence of specific conditions, such as migraine and chronic fatigue syndrome, is associated with an increase in TMD intensity and duration.
颞下颌关节疼痛紊乱症（TMD）是一种常见的面部疼痛疾病。患有TMD的人报告有多种疼痛合并症。TMD患者中纤维肌痛和偏头痛的存在与TMD疼痛强度和持续时间的增加有关。然而，关于疼痛合并症数量增加与TMD疼痛之间关系的数据很少。本研究的目的是：首先评估合并症数量增加与TMD疼痛强度和持续时间增加之间的关联程度；其次评估特定合并症的存在与TMD疼痛强度和持续时间增加之间的关联程度。
样本包括180名在波士顿和蒙特利尔诊所寻求TMD治疗的人。使用TMD的研究诊断标准诊断TMD。数字疼痛评分量表评估TMD疼痛强度，参与者在研究问卷中提供他们的TMD疼痛持续时间。偏头痛、慢性疲劳综合征、肠易激综合征、间质性膀胱炎和不安腿综合征的合并症通过5份经过验证的诊断问卷进行诊断。通过线性回归分析关联，并控制混杂因素。
存在的合并症数量与TMD疼痛强度之间存在正相关（p < 0.01），存在的合并症数量与TMD疼痛持续时间之间也存在正相关（p < 0.01）。此外，偏头痛的存在与TMD疼痛强度呈正相关（p < 0.01），慢性疲劳综合征的存在与TMD疼痛强度呈正相关（p < 0.05），与TMD疼痛持续时间呈正相关（p < 0.01）。当将TMD患者分为不同组时, 这些关联在肌筋膜疼痛组中没有变化，而在非肌筋膜疼痛组中，合并症数量与TMD疼痛持续时间之间的关系是唯一仍然存在的。
本研究表明，合并症数量与TMD疼痛持续时间和强度呈正相关。特定疾病的存在，如偏头痛和慢性疲劳综合征，与TMD强度和持续时间的增加有关。
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