Quality of life in temporomandibular disorder patients with localized and widespread pain

  • Maísa Soares Gui
  • Marcele Jardim Pimentel
  • Marta Cristina da Silva Gama
  • Glaucia Maria Bovi Ambrosano
  • Célia Marisa Rizzatti Barbosa


Aim: To compare temporomandibular (TMD) subgroups classified according to the presence of localized pain (LP) or widespread pain (WP) in order to assess the quality of life domains and verify which components affect most the functional capacity of facial pain patients. Methods: A cross-sectional study was conducted and the Short Form-36 Health Survey was applied in order to assess quality of life. Thirty-nine TMD/WP patients, 37 TMD/LP patients and 40 subjects free of TMD complaints were evaluated. Results: TMD/WP patients differed significantly from healthy controls in all SF-36 components and TMD/LP patients ranked between them. It was also observed that patients with bodily pain and TMD with WP are respectively, 4.16 and 49.42 times more likely to have low functional capacity. Conclusions: Functional capacity in TMD subgroups was only affected by the presence of bodily pain and WP. These patients feature high chance of low functional capacity. Furthermore, TMD patients with localized and widespread pain share role emotional impairments.


1. Pfau DB, Rolke R, Nickel R, Treede RD, Daublaender M. Somatosensory profiles in subgroups of patients with myogenic temporomandibular disorders and fibromyalgia syndrome. Pain. 2009; 147: 72-83.
2. Ohrbach R, Fillingim RB, Mulkey F, Gonzalez Y, Gordon S, Gremillion H, et al. Clinical findings and pain symptoms as potential risk factors for chronic TMD: Descriptive data and empirically identified domains from the OPPERA case-control study. J Pain. 2011; 12: T27-45.
3. Smith MT, Wickwire EM, Grace EG, Edwards RR, Buenaver LF, Peterson S, et al. Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder. Sleep. 2009; 32: 779-90.
4. Slade GD, Smith SB, Zaykin DV, Tchivileva IE, Gibson DG, Yuryev A, et al. Facial pain with localized and widespread manifestations: Separate pathways of vulnerability. Pain. 2013; 154: 2335-43.
5. Williams DA, Clauw DJ. Understanding fibromyalgia: Lessons from the broader pain research community. J Pain. 2009; 10: 777-91.
6. Weissman-Fogel I, Moayedi M, Tenenbaum H, Goldberg M, Freeman B, Davis K. Abnormal cortical activity in patients with temporomandibular disorder evoked by cognitive and emotional tasks. Pain. 2011; 152: 384-96.
7. Chen H, Slade G, Lim PF, Miller V, Maixner W, Diatchenko L. Relationship between temporomandibular disorders, widespread palpation tenderness, and multiple pain conditions: A case-control study. J Pain. 2012; 13: 1016-27.
8. Fillingim RB, Ohrbach R, Greenspan JD, Knott C, Dubner R, Bair E, et al. Potential psychosocial risk factors for chronic TMD: Descriptive data and empirically identified domains from the OPPERA case-control study. J Pain. 2011; 12: T46-60.
9. Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. conceptual framework and item selection. Med Care. 1992: 473-83.
10. Rhudy JL, Meagher MW. The role of emotion in pain modulation. Curr Opin Psychiatr. 2001; 14: 241-5.
11. Price DD. Psychological and neural mechanisms of the affective dimension of pain. Science. 2000; 288: 1769-72.
12. Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: Review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992; 6: 301-55.
13. Gonçalves DA, Dal Fabbro AL, Campos JA, Bigal ME, Speciali JG. Symptoms of temporomandibular disorders in the population: an epidemiological study. J Orofac Pain. 2010; 24: 270-8.
14. LeResche L, Drangsholt M. Temporomandibular disorders. In: Goldman MB, Troisi R, Rexrode KM, editors. Women and health. 2.ed. London: Academic Press; 2013. p.1367-78.
15. Ware JE, Kosinski M, Keller S. SF-36 physical and mental health summary scales: A user’s manual. Health Assessment Lab; 1994.
16. Oga T, Nishimura K, Tsukino M, Sato S, Hajiro T, Mishima M. A comparison of the responsiveness of different generic health status measures in patients with asthma. Qual Life Res. 2003; 12: 555-63.
17. Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Brazilian- Portuguese version of the SF-36. A reliable and valid quality of life outcome measure. Rev Bras Reumatol. 1999; 39: 143-50.
18. McBeth J, Macfarlane GJ, Benjamin S, Silman AJ. Features of somatization predict the onset of chronic widespread pain: Results of a large population based study. Arthritis Rheum. 2001; 44: 940-6.
19. Shedden Mora M, Weber D, Borkowski S, Rief W. Nocturnal masseter muscle activity is related to symptoms and somatization in temporomandibular disorders. J Psychosom Res. 2012; 73: 307-12.
20. Bradley LA. Recent approaches to understanding osteoarthritis pain. J Rheumatol. 2004; 70: 54-60.
21. Kross E, Berman MG, Mischel W, Smith EE, Wager TD. Social rejection shares somatosensory representations with physical pain. Proc Natl Acad Sci U S A. 2011; 108: 6270-5.
22. Horjales-Araujo E, Demontis D, Lund EK, Vase L, Finnerup NB, Børglum AD, et al. Emotional modulation of muscle pain is associated with polymorphisms in the serotonin transporter gene. Pain. 2013; 154: 1469-76.
23. Venkataramanan V, Gignac M, Dunbar M, Garbuz D, Gollish J, Gross A, et al. The importance of perceived helplessness and emotional health in understanding the relationship among pain, function, and satisfaction following revision knee replacement surgery. Osteoarthr Cartil. 2013; 21: 911-7.
24. Rhudy JL, Williams AE, McCabe KM, Russell JL, Maynard LJ. Emotional control of nociceptive reactions (ECON): Do affective valence and arousal play a role? Pain. 2008; 136: 250-61.
25. Barbosa GAS, Morais MHST. Differential diagnosis between post-polio syndrome symptoms and temporomandibular disorder: clinical case. Braz J Oral Sci. 2013; 12: 57-60.
How to Cite
GUI, Maísa Soares et al. Quality of life in temporomandibular disorder patients with localized and widespread pain. Brazilian Journal of Oral Sciences, [S.l.], p. 193-197, dec. 2016. ISSN 1677-3225. Available at: <https://www.fop.unicamp.br/bjos/index.php/bjos/article/view/422>. Date accessed: 21 july 2019.
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