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Back pain in relation to musculoskeletal disorders in the jaw-face: a matched case-control study
Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
Umeå University, Faculty of Medicine, Odontology, Clinical Oral Physiology.
2007 (English)In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 131, no 3, 311-319 p.Article in journal (Refereed) Published
Abstract [en]

Back pain and temporomandibular disorders are both common conditions in the population with influence on the human motor system, but a possible co-morbidity between these conditions has not been fully investigated. The aim of this study was to test the hypothesis of an association between long-term back pain and pain and/or dysfunction in the jaw-face region. Back pain was defined as pain in the neck, shoulders and/or low back. The study-population comprised 96 cases with long-term back pain and 192 controls without back pain. We used a screening procedure, a questionnaire and a clinical examination of the jaw function. The questionnaire focused on location, frequency, duration, intensity and impact on daily life of symptoms in the jaw-face and back regions. The analysis was conducted on 16 strata, matched by age and sex for case vs. control, using Mantel-Haenszel estimates of matched odds ratio (OR) and 95% confidence interval (CI) as well as the corrected Mantel-Haenszel chi(2) test. The overall prevalence of frequent symptoms in the jaw-face region, as reported in the questionnaire, was 47% among cases and 12% among controls. The difference was statistically significant (P<0.0001) with a sevenfold odds ratio (CI: 3.9-13.7). Moderate to severe signs from the jaw region were clinically registered among 49% of the cases and 17% of the controls (P<0.0001, OR: 5.2, CI: 2.9-9.2). The results showed statistically significant associations between long-term back pain and musculoskeletal disorders in the jaw-face and indicate co-morbidity between these two conditions.

Place, publisher, year, edition, pages
2007. Vol. 131, no 3, 311-319 p.
Keyword [en]
Back pain; Temporomandibular disorders; Matched case-control study; Co-morbidity; Musculoskeletal disorders; Jaw dysfunction
Identifiers
URN: urn:nbn:se:umu:diva-20972DOI: 10.1016/j.pain.2007.03.018PubMedID: 17459585OAI: oai:DiVA.org:umu-20972DiVA: diva2:210131
Available from: 2009-03-31 Created: 2009-03-31 Last updated: 2017-12-13Bibliographically approved
In thesis
1. On the relationship between spinal pain and temporomandibular disorders
Open this publication in new window or tab >>On the relationship between spinal pain and temporomandibular disorders
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Ryggvärk och käkfunktionsstörning : finns det ett samband?
Abstract [en]

Both spinal pain and temporomandibular disorders (TMD) commonly occur in the general population. Previous studies demonstrate neurophysiologic and biomechanical couplings between the trigeminal and cervical regions. This investigation tested the null hypothesis of no relationship between spinal pain (neck, shoulder and/or low back) and TMD, by using questionnaires and clinical examinations of the jaw function.

In an age- and sex-matched case-control study, the specific aim was to compare the prevalence of signs and symptoms of TMD among cases with long-term spinal pain and controls without spinal pain. The results showed that subjects with spinal pain had signs and symptoms of TMD significantly more often than did controls. The associations remained after excluding all participants with jaw pain. Furthermore, the comorbidity pattern was similar, regardless of location of spinal pain.

In a cross-sectional study, the specific aim was to test whether there is a reciprocal cross-sectional dose-response-like relationship between spinal pain and TMD. Two different designs were used, one with frequency/severity of spinal pain as independent variable, and the other, with frequency/severity of TMD symptoms as independent variable. The analysis showed increasing odds for presence of TMD symptoms with increasing frequency/severity of spinal pain, and increasing odds for presence of spinal pain with increasing frequency/severity of TMD symptoms.

In a case-control study within a 2-year prospective cohort, the specific aim was to test whether there is a reciprocal temporal relationship between signs and symptoms in trigeminally, and symptoms in spinally, innervated areas. Incidence of symptoms in these areas was analyzed in relation to presence of spinal pain, headaches, and signs and symptoms of TMD at baseline. The main findings were that presence of signs of TMD at baseline increased the onset of spinal pain and symptoms in the trigeminal area, and that spinal pain increased the onset of symptoms in the trigeminal area. An augmentation effect between the significant baseline variables was observed for the incidence of headaches and jaw pain.

In conclusion, the investigation demonstrated a cross-sectional and temporal relationship between spinal pain and TMD; thus, the null hypothesis was rejected. The results indicate common pathophysiological mechanisms in the development of spinal pain and TMD. The comorbidity and reciprocal influence that were found call for an integrated and multidimensional approach in the management of individuals with long-term spinal pain and TMD.

Place, publisher, year, edition, pages
Umeå: Umeå university, 2010. 63 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 109
Keyword
back pain, comorbidity, cross-sectional, dose-response, headaches, matched case-control, musculoskeletal disorders, prospective cohort, spinal pain, temporomandibular disorders (TMD)
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-31240 (URN)978-91-7264-920-0 (ISBN)
Public defence
2010-02-26, By 1D, Sal D, Tandläkarhögskolan, Umeå, 13:30 (Swedish)
Opponent
Supervisors
Available from: 2010-02-05 Created: 2010-02-03 Last updated: 2010-02-05Bibliographically approved

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