Importance of Pain Drawing Profiles and Their Association With Pain Intensity/Interference and Clinical TMD Diagnoses Among Tertiary Care TMD Pain Patients

Abstract

Background

Body pain widespreadness may be related to biopsychosocial impact in TMD (temporomandibular disorders) pain patients.

Objectives

The aim was to assess, by using pain drawings (PDs), the whole-body pain locations/widespreadness and their association with pain-related intensity/interference and clinical Axis I diagnoses among Finnish tertiary care TMD pain patients using the DC/TMD-FIN (Diagnostic Criteria for TMD-FIN).

Methods

Based on PDs, 197 TMD pain patients were divided into PD profile subgroups: PD-1 (local head/face pain), PD-2 (regional head and neck/shoulder pain) and PD-3 (widespread pain). Using the Graded Chronic Pain Scale 2.0 (GCPS 2.0) assessing pain-related intensity/interference, the patients were classified into TMD subtypes (1 = uncompromised, 2 = moderately, 3 = severely compromised). Based on quantitative analysis of PDs, PD score was calculated, considering the pain widespreadness. Differences between PD profile subgroups in TMD subtypes, PD scores and Axis I diagnoses were evaluated with Independent Samples Kruskal–Wallis and chi-squared tests and pairwise comparisons with Mann–Whitney U test with Bonferroni correction. PD score sum was explored by linear regression with age, sex, Axis I diagnoses and TMD subtype as independent variables.

Results

Patients were evenly distributed by PD profiles. Patients with widespread PD-3 profiles were significantly more often classified into TMD subtype 3, had higher PD scores and more pain-related Axis I diagnoses as compared to local PD-1 and regional PD-2.

Conclusion

Among TMD pain patients widespread pain associates with biopsychosocial impact. PD is an important adjunct tool in biopsychosocial Axis II assessment of TMD pain patients for treatment planning and personalised care.