RESEARCH - Jaw pain: its prevalence and meaning in patients with RA, OA, and fibromyalgia

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J Rheumatol. 2005 Dec;32(12):2421-8.

Jaw pain: its prevalence and meaning in patients with rheumatoid arthritis,

osteoarthritis, and fibromyalgia.

Wolfe F, Katz RS, Michaud K.

National Data Bank for Rheumatic Diseases, University of Kansas School of

Medicine, Wichita, Kansas 67214, USA. fwolfe@...

OBJECTIVE. Jaw pain may occur in rheumatoid arthritis (RA), osteoarthritis

(OA), and fibromyalgia (FM). We investigated the prevalence and correlates

of jaw pain, and whether jaw pain is increased in RA, where intrinsic

articular disease can be noted radiographically, or is a manifestation of a

generalized pain problem. METHODS: We analyzed data from 22,720 patients

participating in a longitudinal outcome study of rheumatic diseases,

including 17,683 with RA, 4,011 with OA, and 1,026 with FM. Jaw pain was

considered to be present if a patient indicated it in either the left or

right jaw. In addition to standard rheumatic disease measures, we also

obtained self-report assessments that included a count of painful

nonarticular regions (the regional pain score, RPS), a joint count, and a

count of symptoms. RESULTS: The age and sex adjusted rate of jaw pain was

18.7% in RA, 18.6% in OA, and 35.4% in FM. Jaw pain was best predicted by

joint count, RPS, and a count of somatic symptoms in univariate analyses. In

multivariate analyses jaw pain was predicted by joint count, RPS, symptom

count, and fatigue. The ROC area under the curve for this model was 0.79,

and 82.8% of patients were correctly classified. There was little difference

in predictor variables for RA and OA patients. Covariate adjusted analyses

controlling for age, sex, symptom count, fatigue, RPS, and joint count

predicted jaw pain in 14.7% (95% CI 14.1 to 15.3) of RA and 11.6% (95% CI

10.6 to 12.7) of OA patients. This difference, 3.1%, may represent the

increment in jaw pain attributable to RA.

CONCLUSION: Jaw pain is present in about 19% of patients with RA and OA, and

is primarily a marker for a general pain increase and symptom sensitivity

problem. Patients who have jaw pain have worse outcomes manifested by

decreased functional ability, lower household income, and decreased quality

of life. Variables not usually formally measured in clinical practice best

identify this problem: self-reported joint count, symptom count, count of

painful regions (RPS), and a visual analog scale for fatigue.

PMID: 16331775

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=16331775 & itool=iconabstr & query_hl=10 & itool=pubmed_DocSum

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