The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study

BMC Musculoskelet Disord. 2019 Dec 29;20(1):631. doi: 10.1186/s12891-019-3003-4.


Background: Patients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. Therefore, this study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data.

Methods: A total of 12,375 TMD patients from the Korean National Health Insurance Review and Assessment database were analyzed. Controls were selected using propensity score-matching. The McNemar test, chi-square test, and paired t-test were used to compare the prevalence and severity of spinal pain between cases and matched controls. Logistic regression and linear regression models were used to analyze factors affecting the prevalence and severity of spinal pain in patients with TMD.

Results: The annual period prevalence of TMD was 1.1%. The prevalence was higher in younger individuals than in individuals of other ages and was higher in women than in men. The medical expenditure for TMD per person was $86. Among TMD patients, 2.5% underwent surgical procedures and 0.3% were hospitalized. The prevalence of spinal pain in patients with TMD was 48%, whereas that in the control group was 34%. Increased severity of TMD was associated with an increased probability of spinal pain. The medical expenditure, mean number of visits, and lengths of treatment for spinal pain were greater for patients with TMD than for controls ($136 vs. $81, 4.8 days vs. 2.7 days, 5.5 days vs. 3.3 days). Higher TMD grade was associated with greater differences in average medical expenditure, number of visits, and lengths of treatment for spinal pain between cases and controls. Additionally, for women, living in a rural area and having an older age and more severe TMD were associated with a greater probability of spinal pain and higher medical expenditure related to spinal pain.

Conclusion: A strong association was observed between the presence of TMD and the presence of spinal pain. The association became stronger as the severity of TMD increased, indicating a positive correlation between the severity of TMD and spinal pain.

Keywords: Back pain; Health insurance review and assessment National Patients Sample (HIRA-NPS); Medical service use; Musculoskeletal pain; Propensity score matching; Temporomandibular joint pain.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Female
  • Humans
  • Male
  • Middle Aged
  • Musculoskeletal Pain / diagnosis
  • Musculoskeletal Pain / epidemiology*
  • Pain Measurement
  • Prevalence
  • Propensity Score
  • Republic of Korea / epidemiology
  • Risk Assessment
  • Risk Factors
  • Rural Health / statistics & numerical data
  • Severity of Illness Index
  • Sex Factors
  • Spinal Diseases / diagnosis
  • Spinal Diseases / epidemiology*
  • Temporomandibular Joint Disorders / diagnosis
  • Temporomandibular Joint Disorders / epidemiology*
  • Young Adult