Orofacial Pain and Non-Specific Physical Symptoms After Whiplash Trauma

Objectives: There is a close relationship between the jaw and neck regions and orofacial pain is commonly reported after whiplash trauma. The pathophysiology behind the development of orofacial pain following whiplash trauma is unclear. It has been shown that pain in the jaw region in the acute stage after whiplash trauma is related to the intensity of neck pain, but it may also be related to other factors. The aim was to analyse jaw pain after a recent whiplash trauma in relation to non-specific physical symptoms and depression.

Methods: Ninety-four individuals (53 women, 41 men, mean age 35.3 yrs) were examined within three weeks after a whiplash trauma and compared to a control group of 117 individuals (67 women, 50 men, mean age 33.9 yrs) without history of neck trauma. Participants rated characteristic pain intensity (CPI) in the jaw and neck regions on a numerical rating scale, and completed the Non-specific physical symptoms and the Depression subscales of the Symptoms-Checklist-90R (SCL-90R). The non-specific physical symptoms were further analyzed with and without inclusion of the pain-related items.
Results: Individuals with a recent neck trauma reported higher intensity of neck and jaw pain compared to controls (P<0.0001). The neck trauma group also had higher scores for physical symptoms (1.0, P<0.0001), non-pain physical symptoms (0.7, P<0.0001) and depression (0.9, P<0.0001) compared to the control group (0.3, 0.2 and 0.4, respectively). For the cases, there was a moderate positive correlation between jaw pain and neck pain (r=0.46, P<0.0001), physical symptoms (r=0.60, P<0.0001), and non-pain physical symptoms (r=0.60, P<0.0001). There was a low correlation between jaw pain and grade of depression (r=0.32, P=0.001).
Conclusions: The results indicate that orofacial pain following whiplash trauma is related not only to neck pain, but also to the severity of non-specific physical symptoms, and to less extent to the degree of depression.