title: Does a dose-response relation exist between spinal pain and temporomandibular disorders?
abstract: BACKGROUND
  The aim of this study was to test whether a reciprocal dose-response relation exists between frequency/severity of spinal pain and temporomandibular disorders (TMD).
  
  
  METHODS
  A total of 616 subjects with varying severity of spinal pain or no spinal pain completed a questionnaire focusing on symptoms in the jaw, head and spinal region. A subset of the population (n = 266) were sampled regardless of presence or absence of spinal pain. We used two different designs, one with frequency/severity of spinal pain, and the other, with frequency/severity of TMD symptoms as independent variable. All 616 participants were allocated to four groups, one control group without spinal pain and three spinal pain groups. The subjects in the subset were allocated to one control group without TMD symptoms and three TMD groups. Odds ratios (ORs) were calculated for presence of frequent TMD symptoms in the separate spinal pain groups as well as for frequent spinal pain in the separate TMD groups.
  
  
  RESULTS
  The analysis showed increasing ORs for TMD with increasing frequency/severity of spinal pain. We also found increasing ORs for spinal pain with increasing frequency/severity of TMD symptoms.
  
  
  CONCLUSIONS
  This study shows a reciprocal dose-response-like relationship between spinal pain and TMD. The results indicate that these two conditions may share common risk factors or that they may influence each other. Studies on the temporal sequence between spinal pain and TMD are warranted.
authors.affiliation: Department of Research and Development, Sundsvall Hospital, 85186 Sundsvall, Sweden. birgitta@wiesinger.se
authors.forename: Birgitta
authors.initials: B
authors.lastname: Wiesinger
authors.forename: Hans
authors.initials: H
authors.lastname: Malker
authors.forename: Erling
authors.initials: E
authors.lastname: Englund
authors.forename: Anders
authors.initials: A
authors.lastname: Wänman
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000453:epidemiology / Q000503:physiopathology; D016017:Odds Ratio; D010147:Pain Measurement / Q000379:methods*; D012307:Risk Factors; D020069:Shoulder Pain / Q000453:epidemiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013705:Temporomandibular Joint Disorders / Q000453:epidemiology / Q000503:physiopathology*; D055815:Young Adult