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Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder: A Cross-Sectional Study.


ABSTRACT: High-impact (disabling) pain diminishes the quality of life and increases health care costs. The purpose of this study was to identify the variables that distinguish between high- and low-impact pain among individuals with painful temporomandibular disorder (TMD). Community-dwelling adults (N?=?846) with chronic TMD completed standardized questionnaires that assessed the following: 1) sociodemographic characteristics, 2) psychological distress, 3) clinical pain, and 4) experimental pain. We used high-impact pain, classified using the Graded Chronic Pain Scale, as the dependent variable in logistic regression modeling to evaluate the contribution of variables from each domain. Cross-validated area under the receiver operating characteristic curve (AUC) quantified model discrimination. One-third of the participants had high-impact pain. Sociodemographic variables discriminated weakly between low- and high-impact pain (AUC?=?.61, 95% confidence interval [CI]?=?0.57, 0.65), with the exception of race. An 18-variable model encompassing all 4 domains had good discrimination (AUC?=?0.79, 95% CI?=?0.75, 0.82), as did a simplified model (sociodemographic variables plus catastrophizing, jaw limitation, and number of painful body sites) (AUC?=?0.79, 95% CI?=?0.76, 0.82). Duration of pain, sex, and experimental pain testing results were not associated. The characteristics that discriminated most effectively between people with low- and high-impact TMD pain included clinical pain features and the ability to cope with pain. PERSPECTIVE: This article presents the results of a multivariable model designed to discriminate between people with high- and low-impact pain in a community-based sample of people with painful chronic TMD. The findings emphasize the importance of catastrophizing, jaw limitation, and painful body sites associated with pain-related impact.

SUBMITTER: Miller VE 

PROVIDER: S-EPMC6424335 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder: A Cross-Sectional Study.

Miller Vanessa E VE   Poole Charles C   Golightly Yvonne Y   Barrett Deborah D   Chen Ding-Geng DG   Ohrbach Richard R   Greenspan Joel D JD   Fillingim Roger B RB   Slade Gary D GD  

The journal of pain 20181004 3


High-impact (disabling) pain diminishes the quality of life and increases health care costs. The purpose of this study was to identify the variables that distinguish between high- and low-impact pain among individuals with painful temporomandibular disorder (TMD). Community-dwelling adults (N = 846) with chronic TMD completed standardized questionnaires that assessed the following: 1) sociodemographic characteristics, 2) psychological distress, 3) clinical pain, and 4) experimental pain. We used  ...[more]

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