Quality of Life for myogenous TMD and other pain disorders

Objectives: Patients with myogenous Temporomandibular Disorders (TMD) report pain in facial areas and frequently also in neck or shoulder areas that may affect Health-Related Quality of Life (HRQoL). The aim was to determine HRQoL for myogenous TMD and, using data from the literature with age and gender matching as much as possible, to compare this HRQoL level to that for other types of pain patients suffering from headache or diseases or disorders affecting muscles or joints in general. Methods: HRQoL was examined in 112 patients using two generic questionnaires, i.e. the Nottingham Health Profile (NHP) and Euroqol (both EQ-5D and EQ-VAS). Whereas NHP yields a profile across 6 health areas (higher scores, worser HRQoL), EQ yields a utility value, i.e. the preference that a patient assigns to a particular health state (higher value, better HRQoL). Results: Myogenous TMD was related to a relatively high level of HRQoL, with mean NHP scores which varied within a range from 8.3 (out of 100; area physical immobility) to 27.6 (area energy), with a score of 16.4 for the area pain. Euroqol also indicated a relatively high level of HRQoL for myogenous TMD, with a mean value of 0.725 for the EQ-5D-index and an EQ-VAS score of 70.0 %. While HRQoL for myogenous TMD is better than for patients suffering from rheumatoid arthritis, chronic muculoskeletal pain or fybromyalgy, it is similar to that of selected headache groups with similar age and gender ratio, i.e. patients suffering from migraine or tension headache. Conclusion: Like for headache, HRQoL for myogenous TMD is considerably affected by this disorder. The use of generic questionnaires for measuring HRQoL is therefore recommended as a tool for evaluating therapy effect in Randomised Clinical Trials in addition to the use of disease-specific instruments.