A large percentage of patients with craniomandibular (CMD) and craniocervical (CCD) disorders — musculoskeletal conditions that affect the jaw and the neck — also have fibromyalgia, according to a study by researchers at the University of Heidelberg in Germany.
The findings suggest that these pain-related conditions are linked, underscoring the need for a multidisciplinary diagnostic approach when examining patients with head and jaw pain.
It is unknown if the underlying fibromyalgia causes the two conditions, or if CMD and CCD influence the development of fibromyalgia.
In the study, “Fibromyalgia in patients with chronic CCD and CMD – A retrospective study of 555 patients,” researchers reviewed patient medical records to screen for symptoms of fibromyalgia.
The report, published in the The Journal of Craniomandibular & Sleep Practice, showed that 351 patients — 63% of the cohort analyzed — met diagnostic criteria for fibromyalgia. The group’s average age was 45, and 70% were women.
Almost all of the patients (96%) had pain lasting longer than six months, and 71% experienced pain in a large area of the body.
The analysis showed that patients who met fibromyalgia criteria had higher scores on the widespread pain index (WPI), a checklist indicating where on the body a patient experienced pain in the last week, and higher symptom severity scores compared with patients who did not have fibromyalgia.
They also had higher levels of exhaustion, cognitive impairment, disturbed sleep, dizziness, and heart problems compared with people who did not meet fibromyalgia criteria.
A large percentage of the fibromyalgia patients (83%) had a condition of facial asymmetry known as facial scoliosis. Because this condition develops after several years with CMD, researchers believe the number reflected the percentage of patients with a long-term diagnosis.
Researchers argued that the link between the muscle conditions in the head and fibromyalgia underscored the complexity of diagnosis. It also calls for a multidisciplinary approach to diagnosis, they wrote.
The study is not the first to note a relationship between neck and jaw pain and fibromyalgia. Several studies have previously reported that muscle conditions in the head can influence other areas of the body, including the shoulders, the lower back, the hips, and even the feet.
Several treatments exist to relieve the pain and symptoms of CMD and CCD, and the research team believes that specific treatment of these conditions in patients with simultaneous fibromyalgia might have a positive impact on fibromyalgia symptoms and the patient’s quality of life.