A new article in the Journal of Oral Rehabilitation looks at wide spread body pain particularly musculoskeletal pain and joints.
In a study with 337 participants it was found that those patients with TMD disorders were 5.5 times more likely to present with other areas of joint pain compared to those without TMD.
TMD muscle disorders, usually MPD or myofascial pain and dysfunction were more like to have more pain locations elsewhere in the body.
In general widespread pain and multiple pain locations were common in TMD patients. Patient without TMD were most likely to have knee pain if joint pain existed.
Another Article in the Journal of Oral Rehabilitation looked at patients with Myotonic muscle dystrophy. Comparing these patients signs and symptoms of TMJ disorders compared to a non TMD control and a second control of TMD patients. Statistically the Myotonic muscle dystrophy patients were almost identical to the TMD patient group.
Essentially, the Myotonic muscle dystrophy patients were the same as the TMD patients without Myotonic muscle dystrophy.
In 1998 Shimshak et al published in Cranio an article looking at medical expenses in patient who carried a TMD and his research showed a 300% increase in medical expenses in every field of medicine in patients carrying a TMD diagnosis except obstetrics.
Both of these studies seem to support the work of Shimshak.
The question of causality vs correlation needs to be considered. This is a more difficult study but many clinicians and patients relate how wide spread problems improve during treatment.
It would be interesting to see if treating TMD symptoms in Myotonic muscle dystrophy patients would improve wide spread symptms as well.
J Oral Rehabil. 2017 Jan;44(1):9-15. doi: 10.1111/joor.12457.
Association between temporomandibular disorders and pain in other regions of the body.
Bonato LL1,2, Quinelato V2, De Felipe Cordeiro PC2, De Sousa EB3,4, Tesch R5,6,7, Casado PL8.
The pain from temporomandibular disorder (TMD) is often associated with physical symptoms of other chronic pain disorders and comorbidities, such as generalised muscle and joint pain. However, this association is not widely studied. To evaluate the prevalence of comorbid pain in joints, specifically in the knees, hips, ankles, shoulders, wrists and elbows, in individuals with and without TMD. We evaluated 337 patients from a public hospital in the city of Rio de Janeiro, Brazil. The Research Diagnostic Criteria for TMD questionnaire were used for the diagnosis of TMD. To assess the presence of other joint pain, the patients were asked to answer questions considering: the presence of pain in the knee, hip, ankle, shoulder, wrist and elbow joints and time duration of pain. Individuals with TMD are 5·5 times more likely to present with other joint pain compared with those without the disorder. TMD muscle disorders were most associated with a higher number of pain at the other locations. There was a significant association between the presence of pain at the other locations, muscle (P < 0·001) and joint disorders (P = <0·001), as well as age advance, in TMD participants, showed to be a covariate factor for pain at the other locations. Individuals with TMD showed a high prevalence of pain in other joints of the body when compared with individuals without the disorder, and knee pain was the most prevalent pain complaint.
© 2016 John Wiley & Sons Ltd.
arthralgia; central nervous system sensitisation; comorbidity; facial pain; myalgia; temporomandibular joint disorders
J Oral Rehabil. 2017 Jun 10. doi: 10.1111/joor.12534. [Epub ahead of print]
Temporomandibular dysfunction in adult patients with myotonic dystrophy (DM1).
Mejersjö C1, Kiliaridis S2.
Myotonic muscle dystrophy is a systemic disease with early engagement of the facial muscles. Our aim was to study dysfunction of the temporomandibular system in patients with ‘classic’ dystrophia myotonica (DM1) and compare it with TMD patients and healthy controls. The study included 27 referred patients with DM1, 18 women and nine men, aged 30-62 years, and two matched control groups: patients with temporomandibular disorders symptoms (TMD) and healthy controls, both groups were consecutive patients. The patients answered questions regarding facial pain, jaw function and dysfunction. A clinical examination of the temporomandibular system including the occlusion was performed, and the maximum bite force and finger forces were measured. Among the DM1 patients, 33% reported difficulty biting off, and 22% had difficulty chewing, avoiding foods like meat and raw vegetables, and 37% of the DM1 patients scored their pain and discomfort as moderate to fairly severe. Their main complaints were TMJ clicking and locking, difficulty opening wide and tiredness. They had more clinical signs of dysfunction compared with the controls (P < 0·001), but no statistically significant difference to the TMD patients. The maximum bite force in DM1 patients was impaired compared to both the TMD patients and the controls (P < 0·001). Significantly more occlusal interferences were found in DM1 patients and were associated with chewing difficulties (P < 0·001). In conclusion, patients suffering from DM1 had an increased prevalence of TMD symptoms, reported impaired chewing function and had a decreased maximum bite force.
© 2017 John Wiley & Sons Ltd.
bite force; jaw locking; neuromuscular disease; temporomandibular disorders; temporomandibular joint clicking
PMID: 28600825 DOI: 10.1111/joor.12534