Improvement in patients with a TMD-pain report. A 6-month follow-up study

Even though chronic TMD pain tends to persist in most patients, some chronic patients show improvement. It is largely unknown which factors contribute to the improvement of chronic pain. The aim of this study is to investigate which factors, from a biopsychosocial perspective, help to predict improvement in patients with a report of TMD pain. Methods: Subjects with a report of TMD pain were recruited in seven TMD clinics. They received a baseline questionnaire which included a wide range of possible predictors for improvement. After 6 months they received a follow-up questionnaire which included a measure to determine which participants were improved or not improved. To study which predictive variables were associated with improvement, multiple regression models were built. Results: From the 129 patients who responded to the baseline questionnaire, 100 patients also filled in the follow-up questionnaire (85% women, mean age (years) +/- s.d. = 46.0 +/- 13.8). Fifty percentage of these subjects had improved at the 6-month follow-up. Pain duration was the strongest (negative) predictor for 6-month improvement (P = 0.009). Also the number of care providers (P = 0.017) and the degree of hindrance on function (P = 0.045) helped to predict improvement. Conclusions: The duration of the TMD-pain complaint, the number of care practitioners attended and the degree of hindrance on function (negatively) helped to predict 6-month improvement. No evidence is found to support the role of psychological or social factors on the improvement in patients with a report of TMD pain.