Journal of pain research · 2026
Orofacial Pain at a Tertiary Clinic: Comorbidities and Psychological Conditions Using the International Classification of Orofacial Pain (ICOP) Criteria.
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Brauckhoff Lise Lotte, Haavik Celine Messaoudi, Haug Sivakami Rethnam, Rosén Annika
Аннотация
PURPOSE: To characterize a patient group with refractory orofacial pain (OFP) at a tertiary pain clinic with emphasis on subtype distribution, comorbidities, sex differences and psychological factors.
PATIENTS AND METHODS: This retrospective study reviewed 98 consecutive patients assessed at the National Unit of Orofacial Pain, Haukeland University Hospital, Bergen, Norway (2017-2021). All patients were investigated by an interdisciplinary team that used a structured clinical interview and assessments and patients completed a series of standardized questionnaires that formed the basis for the final diagnosis and treatment plan. The International Classification of Orofacial Pain (ICOP-2020) was launched later and therefore retrospectively used forming the basis for this study. Five primary subtypes were analyzed: primary myofascial orofacial pain (pMOP), post-traumatic trigeminal neuropathic pain (PTTNP), persistent idiopathic facial pain (PIFP), trigeminal neuralgia (TN) and burning mouth syndrome (BMS). Secondary MOP (sMOP) was recorded when myalgia co-occurred with another primary diagnosis. Descriptive statistics, χ 2-tests and one-way ANOVA was performed.
RESULTS: The most frequent diagnosis was pMOP (60.2%), followed by PTTNP (20.4%), PIFP (14.3%), TN (4.1%), and BMS (3.1%). Twenty-five patients had more than one diagnosisa(aPercentages do not sum to 100%. A total of 25 patients with overlapping diagnoses, including 23 patients with secondary MOP and 2 patients with dual primary diagnoses.). Significantly more women (82.6%) had OFP (p<0.05). Patients with pMOP experienced longest mean pain duration (9.9 years) and reported comorbidities such as body pain, headaches and arthritis more frequently than non-MOP groups (p < 0.05). sMOP was present in 75% of PTTNP cases (p = 0.0038). Psychometric and functional measures varied across subtypes: patients with pMOP exhibited the highest scores on HADS (15.3), MFIQ (14.4), and RS (7.0).
CONCLUSION: Refractory OFP is dominated by pMOP and female patients. The strong association between PTTNP and sMOP suggests early combined management of neuropathic- and muscle pain which may limit chronification. Together, our findings support a personalized, interdisciplinary approach to OFP that can improve diagnostic precision and optimize long-term patient outcomes.
PATIENTS AND METHODS: This retrospective study reviewed 98 consecutive patients assessed at the National Unit of Orofacial Pain, Haukeland University Hospital, Bergen, Norway (2017-2021). All patients were investigated by an interdisciplinary team that used a structured clinical interview and assessments and patients completed a series of standardized questionnaires that formed the basis for the final diagnosis and treatment plan. The International Classification of Orofacial Pain (ICOP-2020) was launched later and therefore retrospectively used forming the basis for this study. Five primary subtypes were analyzed: primary myofascial orofacial pain (pMOP), post-traumatic trigeminal neuropathic pain (PTTNP), persistent idiopathic facial pain (PIFP), trigeminal neuralgia (TN) and burning mouth syndrome (BMS). Secondary MOP (sMOP) was recorded when myalgia co-occurred with another primary diagnosis. Descriptive statistics, χ 2-tests and one-way ANOVA was performed.
RESULTS: The most frequent diagnosis was pMOP (60.2%), followed by PTTNP (20.4%), PIFP (14.3%), TN (4.1%), and BMS (3.1%). Twenty-five patients had more than one diagnosisa(aPercentages do not sum to 100%. A total of 25 patients with overlapping diagnoses, including 23 patients with secondary MOP and 2 patients with dual primary diagnoses.). Significantly more women (82.6%) had OFP (p<0.05). Patients with pMOP experienced longest mean pain duration (9.9 years) and reported comorbidities such as body pain, headaches and arthritis more frequently than non-MOP groups (p < 0.05). sMOP was present in 75% of PTTNP cases (p = 0.0038). Psychometric and functional measures varied across subtypes: patients with pMOP exhibited the highest scores on HADS (15.3), MFIQ (14.4), and RS (7.0).
CONCLUSION: Refractory OFP is dominated by pMOP and female patients. The strong association between PTTNP and sMOP suggests early combined management of neuropathic- and muscle pain which may limit chronification. Together, our findings support a personalized, interdisciplinary approach to OFP that can improve diagnostic precision and optimize long-term patient outcomes.