Background & Aims
Having comorbid pain conditions is common in patients with chronic pain, but the number of comorbid pain conditions seem to differ between various pain disorders. One of the most common disorders with comorbid pains is temporomandibular disorders (TMD). The Chronic Overlapping Pain Conditions Screener (COPCS) is an instrument delivered through the web-based platform Research Electronic Data Capture (RedCap) that has been developed and recently validated. The instrument screens for ten comorbid chronic pain conditions that are recognized by the National Institute of Health.
This study aimed at screen for the presence of comorbid pain conditions in women with jaw muscle pain using the COPCS.
Methods
In a first step, the COPCS was translated into Swedish using two native Swedish forward translators (both specialists in orofacial pain) who thereafter synthesized their translations, one native American English backward translator (ignorant of TMD pain), and an independent reviewer (orofacial pain specialist).
Via social media, 344 women with jaw muscle pain were invited to the study. They completed a brief questionnaire regarding their pain, including the 3Q/TMD screener. If they responded “yes” to any of the two first questions in the 3Q/TMD, had an age 20-45 years, pain during > 3 months, and a characteristic pain intensity (CPI) of > 40/100, they were included.
Included women completed the DC/TMD Axis II questionnaire including demographic variables, questions about orofacial pain and headache, and validated instruments for physical and emotional function, and then the COPCS. Both questionnaires were delivered through RedCap. Data are presented with descriptive statistics.
Results
Fifty women were included in the first step. Of these, 45 completed both questionnaires. Their mean age was 32.6 (SD 6.5) years and body mass index 24.4 (3.8) kg/m2. All, but three, were born in Sweden. The median CPI was 50 (IQR 16). They reported a high frequency of oral parafunctions, with a median OBC score of 33 (IQR 11) but a low median total score for jaw functional limitations, 0.9 (IQR 1.3). Their median levels of depression (PHQ-8) and anxiety (GAD-7) were low, 5 (IQR 4) for both.
According to the COPCS, 5 (11%) of the women had fibromyalgia, all but 3 (93%) had painful TMD, 8 (18%) had low-back pain, 12 (27%) had migraine, 5 (11%) had tension-type headache, 10 (22%) had irritable bowel disorder, 3 (7%) had myalgic encephalomyelitis/chronic fatigue syndrome, 3 (7%) had vulvodynia, 1 (2%) had endometriosis, and 5 (11%) had interstitial cystitis/bladder pain syndrome. Twenty-nine (64%) had 2 or more COPCS, with a median for all of 2 (IQR 2).
Conclusions
This pilot study shows that other comorbid pain conditions were common in this group of women with TMD myalgia, which confirms previous findings. A majority had more than two COPCS with migraine headache and tension-type headache being the most prevalent. It also shows that the 3Q/TMD and TMD Pain Screener show good resemblance in screening for TMD pain.
Thus, the COPCS seems to be a useful instrument for screening for comorbid pain conditions in a TMD pain population.
References
Slade GD, Greenspan JD, Fillingim RB, Maixner W, Sharma S, Ohrbach R: Overlap of five chronic pain conditions: Temporomandibular disorders, headache, back pain, irritable bowel syndrome, and fibromyalgia. J Oral Facial Pain Headache 34:s15-s28, 2020. doi: 10.11607/ofph.2573.
Schrepf A, Maixner W, Fillingim R, Veasley C, Ohrbach R, Smith S, Williams DA. The Chronic Overlapping Pain Condition Screener. J Pain. 2024 Jan;25(1):265-272. doi: 10.1016/j.jpain.2023.08.009.
Ohrbach R, Bjorner J, Jezewski MA, John MT, Lobbezoo F. Guidelines for establishing cultural equivalency of instruments. Committee for translations and protocols. International RDC/TMD consortium network. 2013, May 11. Available from https://ubwp.buffalo.edu/rdc-tmdinternational/other-resources/translation-guidelines.
Presenting Author
Goli Chamani
Poster Authors
Malin Ernberg
DDS, PhD
Karolinska Institutet
Lead Author
Goli Chamani
Karolinska Institutet
Lead Author
Malin Collin
DDS
Lead Author
Nikolaos Christidis
DDS
Karolinska Institutet, Department of Dental medicine
Lead Author
Giancarlo De la Torre Canales
Karolinska Institutet
Lead Author
Topics
- Specific Pain Conditions/Pain in Specific Populations: Orofacial Pain