Dr. Adams' Alabama Headache Blog

The SF-36 is a widely used survey to assess health status from the patient's point of view. This patient based, generic health status assessment survey obtains patient's assessments of their functioning and well-being and perception of their general health. It serves as a disability measurement instrument in 29 countries. The dimensions measured 1) Physical Functioning, PF, 2) Role Physical, RP, 3) Body Pain, BP, 4) General Health, GH, 5) Vitality, VT, 6) Social Finctioning, SF, 7)Role Emotional, RE or the effect on usual role due to physical or emotional health, 8) Mental Health, MH. It was of interest to compare the responses of pain patients seeking treatment for TMD, back, and combined TMD and back pain to determine whether their limitations were similar and to compare these scores with those of the asymptomatic controls. The SF-36 scores of four groups of 30 subjects each were analyzed with the Kruskal-Wallis ANOVA by ranks for independent samples. A seperate ANOVA was performed for each of the 8 dimensions. Mann-Whitney U tests were used to compare scores within each dimension. With the exception of VT, control scores were significantly higher, (greater function, least limitation) than those of the other three groups and chronic back pain scores were significantly smaller than all other groups. TMD and combined TMD/back pain scores were both significantly smaller than the scores of controls and significantly greater than those of chronic back pain patients. The difference in the presence of the back pain factor is probably due to the chronicity of the back pain patients who were specifically diagnosed opposed the the TMD being the presenting symptom in the combined pain group. TMD patients tend to suffer impairment in functioning that is intermediate between asymptomatic patietns and chronic back pain patients. The impact of TMD on dimensions of functioning is clearly revelaed I the scores of the SF-36 suggesting is as an importnant diagnostic instrument for disability in the treatmetn of TMD and the assessment of treatment outcome.