Headache Disability in Orofacial Pain Patients Is Related to Traumatic Life Events

Headache is commonly reported in patients presenting with orofacial pain. It has only recently been demonstrated that headache-related disability is high in orofacial pain patients. Traumatic life events (TLEs) such as sexual abuse, physical abuse, and post-traumatic stress disorder (PTSD) are also common in orofacial pain patients and in the same patients reporting headache. In association with a previously reported study of headache disability in orofacial pain patients, it was noted that Migraine Disability Assessment (MIDAS) scores appeared to be significantly higher in patients with TLEs. To investigate the relationship between TLEs and headache disability in a clinic population of orofacial pain patients. Retrospective study. Four hundred and twenty-six consecutive orofacial pain patient records were reviewed, composed of new patients seen at the Orofacial Pain Center, National Naval Medical Center, Bethesda, MD, from November 2003 through December 2004. Of 426 orofacial pain patients reporting headache, 109 or 41.7% reported TLEs. In patients with TLEs, the mean MIDAS score was 28.81 +/- 37.2 compared with 13.5 +/- 17.9 for patients not reporting TLEs P < .000. MIDAS scores were significantly correlated with TLEs, Spearman correlation coefficient 0.272, P < .010. This is the first study to demonstrate that headache disability is significantly higher in a group of orofacial pain patients with TLEs and is correlated with that report of traumatic events. These findings clearly demonstrate the necessity for providers to consider a history of TLEs in orofacial pain patients presenting with headache.