The effect of fibromyalgia and widespread pain on the clinically significant temporomandibular muscle and joint pain disorders--a prospective 18-month cohort study

J Pain. 2010 Nov;11(11):1155-64. doi: 10.1016/j.jpain.2010.02.009. Epub 2010 May 13.


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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Chronic Disease
  • Cohort Studies
  • Comorbidity
  • Complex Regional Pain Syndromes / complications*
  • Complex Regional Pain Syndromes / epidemiology*
  • Complex Regional Pain Syndromes / therapy
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology
  • Depressive Disorder / therapy
  • Female
  • Fibromyalgia / complications*
  • Fibromyalgia / epidemiology*
  • Fibromyalgia / therapy
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Prospective Studies
  • Temporomandibular Joint Disorders / complications*
  • Temporomandibular Joint Disorders / epidemiology*
  • Temporomandibular Joint Disorders / therapy
  • Young Adult