Improvement and care seeking for temporomandibular-pain complaints: The complexity of chronic pain

"Temporomandibular disorders" (TMD) is a collective term used to describe a group of musculoskeletal conditions occurring in the temporomandibular region. TMD shares features with other chronic musculoskeletal syndromes (such as low back pain and neck pain) including pain, limited range of motion and hindrance in function. About half of the people with TMD-pain complaints seeks care for their complaints. Common treatments that are used are: counseling, physiotherapy and oral appliances, from which most patients benefit. As with other musculoskeletal pain disorders, most patients with an acute TMD pain show fast recovery, regardless of treatment. Especially in those patients with long lasting complaints, treatment success becomes difficult to achieve. In patients who develop persistent complaints, pain can have far-reaching consequences. That is, chronic pain may not only impair physical function, but may also result in mental and emotional difficulties and a diminished quality of life. To improve patient care, particularly for those with long lasting pain complaints, much can be gained by further understanding of the factors that influence the development of chronic pain. Therefore, the aim of this thesis was to improve the understanding of the role of biopsychosocial factors in the development of TMD-pain complaints and care seeking behavior.