The relationship between spinal pain and temporomandibular joint disorders in Korea: a nationwide propensity score-matched study

Doori Kim,Boyoung Jung,Eun-Kyoung Lee,Seong-Gyu Ko

doi:10.1186/s12891-019-3003-4

Doori Kim, Boyoung Jung + Show 2 more

Open Access

https://doi.org/10.1186/s12891-019-3003-4

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Abstract

BackgroundPatients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. Therefore, this study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data.MethodsA total of 12,375 TMD patients from the Korean National Health Insurance Review and Assessment database were analyzed. Controls were selected using propensity score-matching. The McNemar test, chi-square test, and paired t-test were used to compare the prevalence and severity of spinal pain between cases and matched controls. Logistic regression and linear regression models were used to analyze factors affecting the prevalence and severity of spinal pain in patients with TMD.ResultsThe annual period prevalence of TMD was 1.1%. The prevalence was higher in younger individuals than in individuals of other ages and was higher in women than in men. The medical expenditure for TMD per person was $86. Among TMD patients, 2.5% underwent surgical procedures and 0.3% were hospitalized. The prevalence of spinal pain in patients with TMD was 48%, whereas that in the control group was 34%. Increased severity of TMD was associated with an increased probability of spinal pain. The medical expenditure, mean number of visits, and lengths of treatment for spinal pain were greater for patients with TMD than for controls ($136 vs. $81, 4.8 days vs. 2.7 days, 5.5 days vs. 3.3 days). Higher TMD grade was associated with greater differences in average medical expenditure, number of visits, and lengths of treatment for spinal pain between cases and controls. Additionally, for women, living in a rural area and having an older age and more severe TMD were associated with a greater probability of spinal pain and higher medical expenditure related to spinal pain.ConclusionA strong association was observed between the presence of TMD and the presence of spinal pain. The association became stronger as the severity of TMD increased, indicating a positive correlation between the severity of TMD and spinal pain.

Highlights

Patients with temporomandibular joint disorder (TMD) often complain of pain in other areas
Most TMD patients were aged 20–29 years and the incidence tended to decrease with age
After 1:1 propensity score matching, the distributions of all sociodemographic covariates were similar between the two groups (Table 2)

Summary

Introduction

Patients with temporomandibular joint disorder (TMD) often complain of pain in other areas. Several studies have been conducted on spinal pain in TMD patients, but have contained only limited information. This study analyzed the relationship between TMD and spinal pain in greater detail by using nationwide data. According to the 2018 Korea National Health Insurance Service analysis of health insurance claim data, the number of patients with TMD increased by more than 62.8% over 9 years, from 244,708 in 2010 to 398,401 in 2018. One explanation of the accompanying pain, especially spinal pain in TMD patients, is whole-body imbalance. Dysfunction in TMD can affect factors such as postural asymmetry, center of foot pressure, and spine curvature, which could induce spinal pain [9,10,11,12]

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