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- Ohrbach, Richard, et al.
(författare)
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Clinical Characteristics of Pain Among Five Chronic Overlapping Pain Conditions
- 2020
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384. ; 34:Suppl, s. 29-42
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To describe the pain characteristics of five index chronic overlapping pain conditions (COPCs) and to assess each COPC separately in order to determine whether the presence of comorbid COPCs is associated with bodily pain distribution, pain intensity, pain interference, and high-impact pain of the index COPC. Methods: Data were from a convenience sample of 655 US adults, of whom 388 had one or more of the five COPCs: painful temporomandibular disorders, headache, low back pain, irritable bowel syndrome, and/or fibromyalgia. Data were collected using pain location checklists and self-report questions regarding pain attributes. The contributions of the COPCs to reported pain intensity and interference were assessed using multivariable regression models. Results/Conclusion: Heat maps from a pain body manikin illustrated that very little of the body was pain free within these COPCs. All pain attributes were the most severe for fibromyalgia and the least severe for irritable bowel syndrome. Within each index COPC, pain intensity, pain interference, and the proportion of participants with high-impact pain increased with each additional comorbid COPC up to four or more COPCs (including the index COPC) (P < .01). High-impact pain associated with an index COPC was influenced by type and number of comorbid COPCs, largely in a gradient-specific manner.
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- Sharma, Sonia, et al.
(författare)
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Attributes Germane to Temporomandibular Disorders and Their Associations with Five Chronic Overlapping Pain Conditions
- 2020
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Ingår i: Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384. ; 34:Suppl, s. 57-72
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To investigate whether TMD-related characteristics are indeed specific to TMD or whether they are also associated with other chronic overlapping pain conditions (COPCs). Methods: In this cross-sectional study, 22 characteristics related broadly to TMD (eg, jaw kinesiophobia, overuse behaviors, and functional limitation) were measured in 178 painful TMD cases who were also classified according to four COPCs: headache, low back pain, irritable bowel syndrome, and fibromyalgia. Differences in mean subscale scores were compared according to individual chronic pain conditions and according to number of COPCs. Results: Headache, low back pain, irritable bowel syndrome, and fibromyalgia were each associated (P < .05) with higher values of at least one TMD-relevant characteristic. In the multivariable analysis, TMD was independently associated with 20 of the 22 characteristics (P < .01), and other COPCs were associated variably. A critical threshold existed between the number of COPCs and TMD characteristics: all characteristics were elevated for subjects with >= 3 COPCs (P <=.01). Conclusion: The overlap between COPCs and characteristics typically regarded as specific to painful TMD has implications for treatment targeted at both the local TMD condition and the broader pain disorder underlying the COPC(s). In TMD patients, the overall burden of pain from COPCs may create a shift in the pain-processing systems that underlie these TMD-relevant characteristics.
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- Slade, Gary D., et al.
(författare)
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Overlap of Five Chronic Pain Conditions : Temporomandibular Disorders, Headache, Back Pain, Irritable Bowel Syndrome, and Fibromyalgia
- 2020
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Ingår i: The Journal of Oral & Facial Pain and Headache. - : Quintessence. - 2333-0384 .- 2333-0376. ; 34:Suppl, s. 15-28
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To assess cohort retention in the OPPERA project and to compare the degree of overlap between pairs of chronic overlapping pain conditions (COPCs) using a cross-sectional analysis of data from 655 adults who completed followup in the OPPERA study. Methods: Subjects were classified for the absence or presence of each of the five COPCs. The extent of overlap beyond chance was quantified using odds ratios, which were calculated using binary logistic regression models. Results: While overlap was the norm, its magnitude varied according to COPC: 51% of people with headache had one or more overlapping COPCs, and this proportion increased to 90% for people with fibromyalgia. The degree of overlap between pairs of COPCs also varied considerably, with odds ratios being greatest for associations between musculoskeletal conditions (fibromyalgia,temporomandibular disorders, and low back pain) and less pronounced for overlap invoMng headache or IBS. Furthermore, univariate associations between some pairs of COPCs were nullified after adjusting for other COPCs. Conclusion: There was greater overlap between fibromyalgia and either temporomandibular disorders or low back pain than between other pairs of COPCs. While musculoskeletal conditions exhibited some features that could be explained by a single functional syndrome, headache and irritable bowel syndrome did not.
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