E0 ConsensusPreliminaryPEM not requiredSystematic-ReviewPeer-reviewedReviewed
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A systematic review of the comorbidity between Temporomandibular Disorders and Chronic Fatigue Syndrome.
Robinson, L J, Durham, J, Newton, J L · Journal of oral rehabilitation · 2016 · DOI
Quick Summary
This review looked at studies examining how often jaw and facial pain disorders (TMD) occur together with ME/CFS. Researchers found that between 21-32% of people with ME/CFS also reported jaw pain problems, and when ME/CFS was combined with fibromyalgia, this number rose to 50%. However, the quality of existing research on this topic is limited, and better studies with consistent diagnostic methods are needed to understand this connection.
Why It Matters
Both TMD and ME/CFS are thought to involve central nervous system hypersensitivity, suggesting they may share underlying biological mechanisms. Understanding their comorbidity could reveal common treatment targets and help explain why some ME/CFS patients experience severe jaw and facial pain, potentially improving diagnostic and therapeutic approaches.
Observed Findings
21-32% of CFS patients reported having TMD in three studies
50% comorbidity observed in samples with both CFS and fibromyalgia
0-43% of TMD patients reported having CFS, with notable variation by recruitment source
Only six studies met rigorous inclusion criteria, indicating sparse literature on this topic
Inferred Conclusions
A meaningful overlap exists between TMD and CFS that suggests potential shared aetiological mechanisms related to central nervous system sensitisation
Recruit source significantly influences reported comorbidity rates, reflecting differences in patient populations and diagnostic criteria
Current evidence quality is insufficient to determine true comorbidity prevalence or identify common biological pathways
Standardised clinical assessments are needed instead of reliance on patient self-report of prior diagnosis
Remaining Questions
What is the true prevalence of TMD-CFS comorbidity using standardised, objective diagnostic criteria across consistent populations?
What This Study Does Not Prove
This review does not establish causation—it cannot determine whether TMD causes ME/CFS, ME/CFS causes TMD, or if both result from a third underlying mechanism. The wide variation in reported comorbidity (0-50%) and reliance on self-reported diagnoses means the true rate of overlap remains uncertain. The study also does not identify specific shared biological pathways.
Tags
Symptom:PainFatigueSensory Sensitivity
Method Flag:Weak Case DefinitionSmall SampleExploratory OnlyMixed Cohort
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 →
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