Headache disability in orofacial pain patients is related to traumatic life events.

BACKGROUND: Headache is commonly reported in patients presenting with orofacial pain. It has only recently been demonstrated that headache-related disability is high in orofacial pain patients. Traumatic life events (TLEs) such as sexual abuse, physical abuse, and post-traumatic stress disorder (PTSD) are also common in orofacial pain patients and in the same patients reporting headache. In association with a previously reported study of headache disability in orofacial pain patients, it was noted that Migraine Disability Assessment (MIDAS) scores appeared to be significantly higher in patients with TLEs. OBJECTIVES: To investigate the relationship between TLEs and headache disability in a clinic population of orofacial pain patients. DESIGN: Retrospective study. METHODS: Four hundred and twenty-six consecutive orofacial pain patient records were reviewed, composed of new patients seen at the Orofacial Pain Center, National Naval Medical Center, Bethesda, MD, from November 2003 through December 2004. RESULTS: Of 426 orofacial pain patients reporting headache, 109 or 41.7% reported TLEs. In patients with TLEs, the mean MIDAS score was 28.81 +/- 37.2 compared with 13.5 +/- 17.9 for patients not reporting TLEs P < .000. MIDAS scores were significantly correlated with TLEs, Spearman correlation coefficient 0.272, P < .010. CONCLUSIONS: This is the first study to demonstrate that headache disability is significantly higher in a group of orofacial pain patients with TLEs and is correlated with that report of traumatic events. These findings clearly demonstrate the necessity for providers to consider a history of TLEs in orofacial pain patients presenting with headache.

Headache disability in orofacial pain patients.

OBJECTIVE: To retrospectively examine the reported history of and the disability caused by headaches in patients presenting for evaluation and treatment of orofacial pain. BACKGROUND: More than 81% of patients with the chief complaint of pain in the orofacial region concomitantly report pain in other body locations. Among the comorbidities frequently reported with orofacial pain are a variety of different headaches types, including migraines, tension type headaches, and chronic daily headaches. The extent of the disability caused by those headache complaints in a large patient population is unknown. METHODS: The Migraine Disability Assessment (MIDAS) is administered to all patients as a part of the initial assessment at the Orofacial Pain Center. This investigation is retrospectively examined the reported history of and the disability caused by headaches in patients who presented for evaluation and treatment of orofacial pain in the Orofacial Pain Center, National Naval Medical Center, Bethesda, MD, between the dates of 1 September 2003 and 1 December 2004. RESULTS: In the present study 261 (61.3%) patients reported a headache complaint and 100 (38%) fulfilled the criteria for migraine with or without aura. MIDAS scores were reported by 55.3% of 426 patients with the mean score of 23.68. There were no significant differences in MIDAS scores in relation to the presence or absence of an intracapsular disorder. Patients with masticatory and/or cervical myalgia demonstrated significantly higher MIDAS scores when compared to patients without myalgia. CONCLUSIONS: These findings clearly demonstrate the necessity for evaluation of headache and related disability in orofacial pain patients.