Presence of widespread pain predicts comorbidities and treatment response in temporomandibular disorders patients

Objectives Investigate the presence of widespread pain in a well-defined TMD group and analyze its interrelationship with various comorbidities. Also, longitudinally seek the difference in treatment response according to the presence of widespread pain. Subjects and Methods The observational study involved 45 female TMD patients in their 20s. Patients were grouped into localized and widespread pain groups based on the widespread pain index (WPI >= 4). Clinical characteristics and levels of comorbidities were analyzed through physical examination and validated questionnaires. Differences between the groups and the power of pre-treatment WPI in predicting pre-treatment comorbidities and post-treatment pain level improvement were statistically analyzed. Results Patients with widespread pain showed higher somatization and anxiety levels. SF-36 scores were significantly lower and more patients complained of gastrointestinal symptoms. Conventional treatment significantly reduced pain intensity in both groups but less in the widespread pain group. WPI showed significant chances to predict patients showing improvement in pain levels with treatment with a cutoff value of 4. WPI was also effective in differentiating patients that showed a higher level of somatization. Conclusion Widespread pain index could be effectively applied in differentiating those with a higher level of psychological distress and predicting TMD treatment response with further investigations into its reliability.

Automated summary

This study investigated the presence of widespread pain in a well-defined TMD group and found that patients with widespread pain showed higher somatization and anxiety levels. Treatment response was also less in the widespread pain group. The study suggests that the WPI could be a useful tool in predicting TMD treatment response and identifying patients with higher psychological distress.