E2 ModerateModerate confidencePEM unclearCross-SectionalPeer-reviewedMachine draft
Painful temporomandibular disorders are common in patients with postural orthostatic tachycardia syndrome and impact significantly upon quality of life.
Durham, Justin, McDonald, Claire, Hutchinson, Luke et al. · Journal of oral & facial pain and headache · 2015 · DOI
Quick Summary
This study found that people with PoTS (a condition causing rapid heart rate when standing) often also have painful jaw disorders (TMD). Nearly half of the patients studied screened positive for TMD, and those with TMD reported that it significantly worsened their quality of life. The researchers suggest that doctors should routinely check for jaw pain in PoTS patients.
Why It Matters
This study highlights a potentially underrecognized comorbidity in PoTS that significantly impacts functional status and quality of life. Understanding the relationship between PoTS, TMD, and ME/CFS may help clinicians provide more comprehensive care and improve patient outcomes through targeted screening and intervention.
Observed Findings
- 47% of PoTS patients screened positive for painful temporomandibular disorders
- 56% of patients with TMD met Fukuda Criteria for chronic fatigue syndrome (compared to 44% of the total sample)
- TMD was significantly associated with reduced quality of life on PROMIS and HAQ measures (P<0.05)
- No significant physiologic differences were found between PoTS patients with and without TMD
- No significant differences between TMD screening results and previously reported headaches or joint pain
Inferred Conclusions
- Painful TMD is a common comorbidity in PoTS, present in approximately half of this clinical sample
- TMD has a clinically significant negative impact on quality of life in PoTS patients
- Early screening for TMD should be integrated into standard PoTS clinical assessment
- The high prevalence of both TMD and CFS in this PoTS cohort suggests potential shared mechanisms or overlapping populations
Remaining Questions
- What is the mechanistic relationship between PoTS and TMD (shared autonomic dysfunction, similar pathophysiology, or independent comorbidities)?
What This Study Does Not Prove
This study does not establish whether TMD causes PoTS symptoms, results from PoTS, or represents an independent comorbidity. The cross-sectional design cannot determine the temporal relationship or mechanistic link between these conditions. The small sample size and lack of control group limit the ability to generalize findings or rule out selection bias.
Tags
Symptom:PainFatigue
Method Flag:Weak Case DefinitionSmall SampleMixed Cohort
Metadata
- DOI
- 10.11607/ofph.1396
- PMID
- 25905533
- Review status
- Machine draft
- Evidence level
- Single-study or moderate support from human research
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
Spotted an error in this entry? Report it →