Influence of Temple Headache Frequency on Physical Functioning and Emotional Functioning in Subjects with Temporomandibular Disorder Pain

Aims: To investigate the relationship of headache frequency with patient-reported physical functioning and emotional functioning in temporomandibular disorder (TMD) subjects with concurrent temple headache. Methods: The Research Diagnostic Criteria for TMD (RDC/TMD) Validation Project identified, as a subset of 614 TMD cases and 91 controls (n = 705), 309 subjects with concurrent TMD pain diagnoses (RDC/TMD) and temple headache. The temple headaches were subdivided into infrequent, frequent, and chronic headache according to the International Classification of Headache Disorders, second edition (ICHD-II). Study variables included self-report measures of physical functioning (Jaw Function Limitation Scale [JFLS], Graded Chronic Pain Scale [GCPS], Short Form-12 [SF-12]) and emotional functioning (depression and anxiety as measured by the Symptom Checklist-90R/SCL-90R). Differences among the three headache subgroups were characterized by increasing headache frequency. The relationship between ordered headache frequency and physical as well as emotional functioning- was analyzed using linear regression and trend tests for proportions. Results: Physical functioning, as assessed with the JFLS (P .001), SF-12 (P .001), and GCPS (P .001), was significantly associated with increased headache frequency. Emotional functioning,- reflected in depression and anxiety, was also associated with increased frequency- of headache (both P .001). Conclusion: Headache frequency- was substantially correlated with reduced physical functioning and emotional functioning in subjects with TMD and concurrent temple headaches. A secondary finding was that headache was precipitated by jaw activities more often in subjects with more frequent temple headaches. Keywords: health-related quality of life, jaw function, psychosocial status, temporomandibular disorders, tension-type headache