The Effect of Fibromyalgia and Widespread Pain on the Clinically Significant Temporomandibular Muscle and Joint Pain Disorders-A Prospective 18-Month Cohort Study

Although most cases of temporomandibular muscle and joint disorders (TMJD) are mild and self limiting about 10% of TMJD patients develop severe disorders associated with chronic pain and disability It has been suggested that fibromyalgia and widespread pain play a significant role in TMJD chronicity This paper assessed the effects of fibromyalgia and widespread pain on clinically significant TMJD pain (GCPS II IV) Four hundred eighty five participants recruited from the Minneapolis/St Paul area through media advertisements and local dentists received examinations and completed the Graded Chronic Pain Scale (GCPS) at baseline and at 18 months Baseline widespread pain (OR 2 53 P = 04) and depression (OR 5 30 P = 005) were associated with onset of clinically significant pain (GCPS II IV) within 18 months after baseline The risk associated with baseline fibromyalgia was moderate but not significant (OR 2 74 P = 09) Persistence of clinically significant pain was related to fibromyalgia (OR 2 48 P= 02) and depression (OR 2 48 P= 02) These results indicate that these centrally generated pain conditions play a role in the onset and persistence of clinically significant TMJD Perspective Fibromyalgia and widespread pain should receive important consideration when evaluating and developing a treatment plan for patients with TMJD (C) 2010 by the American Pain Society