THE RELATIONSHIP BETWEEN FIBROMYALGIA AND TEMPOROMANDIBULAR DISORDERS- PREVALENCE AND SYMPTOM SEVERITY

Objective, To determine the prevalence of muscular or myofascial tempo romandibular disorders (TMD) in fibromyalgia (FM) and the prevalence o f FM in TMD; and to determine which characteristics best distinguish t he 2 disorders. Methods, 39 consecutive patients with TMD seen in a TM D clinic and 60 patients with FM were examined according to Research D iagnostic Criteria (RDC) for TMD and the American College of Rheumatol ogy 1990 Criteria for the Classification of Fibromyalgia. All patients completed the questionnaires of the RDC and a health status instrumen t that assessed pain, function, sleep disturbance, fatigue, and psycho logical status (CLINHAQ). Results, A small proportion of patients with TMD (18.4%) also had FM, but most of those with FM (75.0%) satisfied criteria for muscular (myofascial) TMD. Patients with FM had lower pai n thresholds and more severe manifestations of all disease measures (e .g., pain, fatigue, sleep, etc.) compared to those with TMD. As might be predicted, they also had more painful body regions. Patients with F M also differed significantly from those with TMD in self-reported wor k ability and health assessment. The features that best differentiate FM from TMD are functional disability, reports of work difficulty, and general dissatisfaction with health. Conclusion, TMD is a local disor der and FM a generalized disorder, and there is less evidence of distr ess in those with TMD. TMD is a separate disorder from FM, but many pa tients with FM have TMD symptoms.