Efficacy of an early intervention for patients with acute temporomandibular disorder-related pain: a one-year outcome study.
BACKGROUND
The authors conducted a randomized clinical trial to evaluate the efficacy of a biopsychosocial intervention for patients who were at high risk (HR) of progressing from acute to chronic temporomandibular disorder (TMD)-related pain.


METHODS
The authors classified subjects' risk using a predictive algorithm and randomized them into an early-intervention (EI) or a nonintervention (NI) group. The EI included cognitive behavioral skills training and biofeedback. The authors assessed pain and psychosocial measures at intake and at a one-year follow-up. Subjects' self-reported pain levels were measured on an analog scale and as a response to palpation.


RESULTS
At one year, EI-group subjects had significantly lower levels of self-reported pain and depression. At one year, more NI-group subjects than EI-group subjects had utilized health care for jaw-related pain. NI-group subjects were 12.5 times as likely to have a somatoform disorder, more than seven times as likely to have an anxiety disorder, and 2.7 times more likely to have an affective disorder at one year, compared with EI-group subjects.


CONCLUSIONS
EI-group subjects had reduced pain levels, improved coping abilities and reduced emotional distress at one year.


CONCLUSIONS
The TMD-related pain experience is complex and requires early identification with a biopsychosocial EI to achieve maximal, sustainable results.
Gatchel
Robert J
RJ
Department of Psychology, College of Science, University of Texas at Arlington, 313 Life Science Building, 501 S. Nedderman Drive, Arlington, Texas 76019-0528, USA. gatchel@uta.edu
Stowell
Anna Wright
AW
Wildenstein
Lynn
L
Riggs
Richard
R
Ellis
Edward
E
D000293:Adolescent; D000328:Adult; D001676:Biofeedback, Psychology; D016009:Chi-Square Distribution; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005157:Facial Pain / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011584:Psychology; D018709:Statistics, Nonparametric; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000628:therapy*