Diagnosis of Temporomandibular Joint Pain in Patients Seen at a Pain Clinic

A retrospective survey of a pain clinic population found 43 patients (2.6% of the total population) who had pain in the temporomandibular joint region. The clinical presentation of these patients did not differ greatly from that observed with typical responsive temporomandibular joint pain; however, important discriminating factors were duration of the pain, a strong history of pain elsewhere in the body, and major psychiatric disturbance. The diagnosis was atypical facial pain in 39 (90%) of the cases; other diagnoses included glossopharyngeal neuralgia and perineural invasion by adenocystic carcinoma. Although the various treatment strategies employed resulted in an improvement of pain in 63% of cases, there was often a subsequent development of pain elsewhere in the body or other disturbances.