Background Chronic orofacial pain is associated with substantial pain-related disability and emotional distress. Understanding the relationship between individuals’ coping strategies and pain-related outcomes is important yet understudied in this population. Purpose To test the cross-sectional association of three coping strategies (pain catastrophizing, kinesiophobia and mindfulness) to four pain-related outcomes (depression, anxiety, pain intensity, and pain-related disability) among individuals with chronic orofacial pain, after accounting for relevant demographic and clinical variables. Methods Individuals (N=303) with heterogeneous chronic orofacial pain (eg, trigeminal neuralgia, other trigeminal neuropathic pain, persistent idiopathic facial pain and other types) completed self-report measures of coping (Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, and the 15-item Five Facet Mindfulness Questionnaire), pain intensity and pain-related disability (Graded Chronic Pain Scale), and PROMIS measure of anxiety and depression. We conducted 4 two-step hierarchical regressions for each of the four pain-related and emotional outcomes, with the first step including demographic and clinical covariates, and the second step including the three coping variables together. Results Pain catastrophizing was the only coping variable significantly associated with pain intensity (B=0.362, SE=0.115, p=0.002, 3% variance explained) and pain-related disability (B =0.813, SE=0.162, p<0.001, 7% variance explained). Pain catastrophizing (B=0.231-0.267, SE=0.046-0.051-0.050, p<0.001), kinesiophobia (B=0.201-0.316, SE=0.081-0.084, p<0.001-0.018), and mindfulness (B=0.231–0.306, SE=0.046-0.067, p<0.001) were each independently associated with symptoms of anxiety and depression, with the largest incremental variance added by catastrophizing (5–8%) and mindfulness (5%). Conclusion Pain catastrophizing appears to be an important intervention target to improve pain intensity, pain-related disability, anxiety and depression among individuals with chronic orofacial pain. Kinesiophobia and mindfulness may be additional treatment targets for interventions to improve anxiety and depression.

No abstract

Orofacial pain affects 10–15% of adults, yet treatments are limited. The gaps in care are frustrating for both patients and providers and can negatively impact patient–provider interactions. These interactions are key because they impact patient-reported outcomes and satisfaction with care. Purpose: Our study aims to understand the nuanced experiences with medical providers among patients with orofacial pain. Methods: In a cross-sectional survey, 260 patients provided written responses describing their experiences with medical providers. Using an inductive–deductive approach to thematic analysis, we identified themes and subthemes and organized them into four domains based on the Patient-Centered Model of Communication. Results: Patients reported feeling hopeless about treatment options, frustrated with lack of provider knowledge, disappointed in ineffective care, and stigmatized and dismissed by providers. Patients also said they learned to advocate for their health, were grateful for effective care, and felt lucky when providers listened and showed compassion. Patients identified key barriers that interfere with care (e.g., insurance, transportation, limited providers, lack of team coordination). Conclusions: Findings can help inform training programs and psychoeducation that target patient–provider communication to improve patient-reported outcomes, the quality of care delivered, and health care utilization and costs.