Study finds evidence that co-occurring painful temporomandibular disorder and headache are associated with worse pain symptoms.
Characteristics that distinguish headache secondary to temporomandibular disorder from headache that is comorbid with TMD.](https://journals.lww.com/pain/Abstract/9900/A_rose_by_another_name__Characteristics_that.167.aspx) Pain. Compared between groups C and B, group C had more patients with a cervicogenic headache classification (P =.007) but not rhinosinusitis (P =.810) or posttraumatic (P =.320) headache classifications. Large effect sizes were observed for the following: Manikin scores of the head, neck, and shoulder; palpation neck familiar pain; palpation body familiar pain; palpation body pain; evoked familiar pain; nonspecific jaw symptoms; evoked pain; TMD pain days; temporomandibular joint function; somatic Tampa Scale for Kinesiophobia (TSK); global Jaw Functional Limitation Scale; TSK activity; total Oral Behaviors Checklist (OBC); and pain-free opening. Effect sizes were large (≥0.8) in 16, medium (0.5 to <0.8) in 16, and small (0.2 to <0.5) in 19. Data for this study were collected between 2014 and 2016 at 4 academic health centers in the United States for the Orofacial Pain: Evaluation and Risk Assessment (OPERA-II) study. The mean age of study participants was 38.3, 38.5, and 37.4 years; and 62.2%, 68.7%, and 74.8% were White, respectively. doi:10.1097/j.pain.0000000000002770 A cervicogenic classification of headache was highest among group C (64.4%) and lowest for group A (22.5%); similarly, group C had the highest rates of rhinosinusitis (17.8%) or posttraumatic (15.3%) headache and group A had the lowest rates (5.0% and 4.4%, respectively). [headache](https://www.clinicalpainadvisor.com/migraine-headache/vascular-health-associated-migraine-risk-among-adult-women/) secondary to the TMD and which is a separate condition from any co-existing primary headache will be associated with yet greater suffering and impact.” Patients with headache without TMD (group A; n=349), patients with co-occurring headache and TMD (group B; n=147), and patients with headache attributed to TMD (group C; n=123) were compared for demographic and clinical features. The pooled cohort of groups B and C had significantly higher rates of irritable bowel syndrome (P =0.000), low back pain (P =.001), and fibromyalgia (P =.000) compared with group A. Groups A, B, and C were composed of 68.2%, 69.4%, and 84.6% women, respectively.