The Relation between Catastrophizing and Kinesiophobia in Individuals with TMD

Objectives: Patients with temporomandibular disorders (TMD) often report multiple somatic symptoms, widespread pain and psychosocial stressors. The aim of this study was to evaluate the relationship between TMD, catastrophizing and kinesiophobia.
Methods: At the Validation Project baseline assessment from 2003 to 2006, a convenience sample of 724 participants aged 18-70 were recruited. The present study was based on 401 participants (333 women, 86 men, mean age 45.8 years) evaluated at follow-up after 5.8-10 years (mean 7.9 years). Of these, 218 participants had a pain-related TMD diagnosis, 111 had TMD without pain, and 63 were pain-free controls. Data was missing for 9 individuals. Participants completed the Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia (TSK) assessing fear of movement, together with Areas of Pain (AOP) and the Patient Health Questionnaire (PHQ-15) assessing somatic complaints.

Results: Compared to controls, participants with TMD pain showed a higher degree of catastrophizing (p=0.017 and more kinesiophobia, somatic symptoms, and areas of pain (all p<0.0001). Participants with non-painful TMD showed a higher degree of kinesiophobia (p=0.0002) than controls. There was a positive correlation between catastrophizing and kinesiophobia for participants with TMD pain (r=0.37, p<0.0001) and non-painful TMD (r=0.53, p<0.001).

Conclusions: The results suggest an association between catastrophizing and fear of movement in individuals with TMD regardless of presence of pain. The overall findings suggest that that evaluating for fear of movement and catastrophizing, as well as widespread pain and multiple non-TMD symptoms can be useful in the assessment and management of patients with TMD.