The relationship between fibromyalgia (FM) & temporomandibular disorders: prevalence & symptom severity

OBJECTIVE: To determine the prevalence of muscular or
myofascial temporomandibular disorders (TMD) in fibromyalgia
(FM) and the prevalence of FM in TMD; and to determine which
characteristics best distinguish the 2 disorders.

METHODS: 39
consecutive patients with TMD seen in a TMD clinic and 60
patients with FM were examined according to Research
Diagnostic Criteria (RDC) for TMD and the American College of
Rheumatology 1990 Criteria for the Classification of
Fibromyalgia. All patients completed the questionnaires of
the RDC and a health status instrument that assessed pain,
function, sleep disturbance, fatigue, and psychological
status (CLINHAQ).

RESULTS: A small proportion of patients
with TMD (18.4%) also had FM, but most of those with FM
(75.0%) satisfied criteria for muscular (myofascial) TMD.
Patients with FM had lower pain thresholds and more severe
manifestations of all disease measures (e.g., pain, fatigue,
sleep, etc.) compared to those with TMD. As might be
predicted, they also had more painful body regions. Patients
with FM also differed significantly from those with TMD in
self-reported work ability and health assessment. The
features that best differentiate FM from TMD are functional
disability, reports of work difficulty, and general
dissatisfaction with health.

CONCLUSION: TMD is a local
disorder and FM a generalized disorder, and there is less
evidence of distress in those with TMD. TMD is a separate
disorder from FM, but many patients with FM have TMD
symptoms.

Plesh O, Wolfe F, Lane N

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