Does a dose-response relation exist between spinal pain and temporomandibular disorders?

Abstract

Background: The aim of this study was to test whether a reciprocal dose-response relation exists between frequency/severity of spinal pain and temporomandibular disorders (TMD).

Methods: A total of 616 subjects with varying severity of spinal pain or no spinal pain completed a questionnaire focusing on symptoms in the jaw, head and spinal region. A subset of the population (n = 266) were sampled regardless of presence or absence of spinal pain. We used two different designs, one with frequency/severity of spinal pain, and the other, with frequency/severity of TMD symptoms as independent variable. All 616 participants were allocated to four groups, one control group without spinal pain and three spinal pain groups. The subjects in the subset were allocated to one control group without TMD symptoms and three TMD groups. Odds ratios (ORs) were calculated for presence of frequent TMD symptoms in the separate spinal pain groups as well as for frequent spinal pain in the separate TMD groups.

Results: The analysis showed increasing ORs for TMD with increasing frequency/severity of spinal pain. We also found increasing ORs for spinal pain with increasing frequency/severity of TMD symptoms.

Conclusion: This study shows a reciprocal dose-response-like relationship between spinal pain and TMD. The results indicate that these two conditions may share common risk factors or that they may influence each other. Studies on the temporal sequence between spinal pain and TMD are warranted.

Figure 1

Spinal pain as independent variable: Prevalence of TMD symptoms and headaches. Prevalence of frequent symptoms in the jaw-face region and headaches among subjects without spinal pain (SP-0), SP-1 subjects with infrequent spinal pain, SP-2 subjects with frequent spinal pain and SP-3 subjects with disabling spinal pain and attending a vocational rehabilitation programme.

Figure 2

Spinal pain as independent variable: Odds ratios and 95% confidence intervals for TMD symptoms and headaches. Odds ratios (ORs) and 95% confidence intervals (CIs) for presence of frequent symptoms in the jaw-face region and headaches among subjects with infrequent spinal pain (SP-1), subjects with frequent spinal pain (SP-2) and patients with disabling spinal pain attending a rehabilitation programme (SP-3), compared with controls (SP-0). ORs and 95% CIs were calculated with binary logistic regression analysis, adjusting for age and sex.

Figure 3

Symptoms of temporomandibular disorders as independent variable: Prevalence of spinal pain. Prevalence of frequent spinal pain among subjects without symptoms of temporomandibular disorders (TMD-0), TMD-1 subjects with infrequent symptoms of TMD, TMD-2 subjects with frequent, mild symptoms of TMD, and TMD-3 subjects with frequent, severe symptoms of TMD.