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J Am Dent Assoc, Vol 131, No 2, 161-171. © 2000 American Dental Association

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JADA Continuing Education

Clinical Characteristics of Those With Regional vs. Widespread Pain

Background. The authors conducted a study to determine whether there are differences in salient clinical characteristics between patients who have both myofascial face pain, or MFP, and comorbid fibromyalgia, or FM, and patients who have MFP but not FM.

Methods. The authors enrolled in the study 162 female subjects who had histories of MFP. In physical examinations at the time of initial consultation, they recorded facial pain signs and symptoms. At the research interview follow-up (seven years postconsultation), participants were screened for a lifetime history of FM and other health problems. In addition, psychiatric interviewers conducted the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Third Edition–Revised, to assess each patient’s history of depression and other psychiatric disorders.

Results. Of the 162 participants, 38 (23.5 percent) reported a history of FM. At the time of treatment for MFP, both the FM and non-FM groups had similar signs and symptoms of MFP. At the time of the research interview follow-up, participants with FM histories were significantly less likely than those without FM histories to report that they were free of MFP. On recall, those with FM histories reported experiencing more symptoms of MFP. Those with FM histories also were more likely to have had major depression and to report somatization symptoms. Finally, those who had FM more commonly had a history of facial pain’s interference with social and occupational functioning and had more severe pain than did those without FM.

Conclusions. Patients who have MFP and a history of widespread pain suggestive of FM are likely to have more persistent and debilitating MFP and to have higher rates of depression and somatization symptoms than those who have no history of widespread pain.

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				L. A. Aaron and D. Buchwald A Review of the Evidence for Overlap among Unexplained Clinical Conditions Ann Intern Med, May 1, 2001; 134(9_Part_2): 868 - 881. [Abstract] [Full Text] [PDF]