Greenbaum T1, Dvir Z1, Winocur E2
1Tel Aviv University, Physical Therapy, Tel Aviv, Israel, 2Tel Aviv University, Dental Medicine, Tel Aviv, Israel
Background: The term temporomandibular disorders (TMD) refers to several common clinical disorders that involve the masticatory muscles, temporomandibular joint and adjacent structures. Upper neck signs, symptoms and hypomobility have been shown to be presented with higher prevalence in patients with temporomandibular (TMD), however the mechanism of this potential association in not well understood.
Purpose: To assess the association between TMD and key performance and pain parameters relating to the upper cervical spine.
Methods: Comparative cohort study
A. Comparison of key performance & pain parameters of the upper cervical spine in 74 TMD patients (pain related TMD/intra-articular TMD/mixed TMD) and 42 healthy controls.
B. Assessment of correlations between key cervical spine and temporomandibular pain & performance parameters
C. Assessment of the prevalence and incidence of cervigogenic headache among TMD patients comparing ´pain related´ (n=37), ´intra-articular´ (n=17) , ´mixed´ (n=20) subgroups & healthy controls (n=42).
Results:
A) Significant impairments were found among ´pain related´ & ´mixed´ TMD groups versus ´intra-articular´ & ´healthy´ groups in several key cervical spine performance & pain parameters: Decreased mobility (Extension range of motion, P 0.05; Flexion-rotation test, P˂0.01), activation and performance scores of the deep cervical flexors muscles (P 0.01) and scores of the neck disability index (P˂0.05).
B) Positive correlation was found between temporomandibular average pain parameters (composite pain index) and forward head posture (r=0.35, p=0.005). C) Clear significantly higher prevalence rates of cervicogenic headache were found among ´pain related´ & ´mixed´ TMD (38% & 35% accordingly) versus ´inra-articular´ & ´healthy´ groups (0% & 4% accordingly).
Conclusion(s): Our results support a relevant clinical association between ´pain related´ & ´mixed´ TMD with specific key pain & performance impairments in the upper cervical spine, including high prevalence of cervicogenic headache. ´intra articular´ TMD patients on the other hand demonstrate no significant cervical spine impairments compared to their matched healthy controls.
Implications: Upper cervical spine pain & performance impairments are very likely to be present in people with painful temporomandibular disorders. These impairments may play a role in both etiology and prognosis of TMD patients and therefore should be assessed in all painful TMD patients and managed if presented. Further research in needed for exploring the potential causative connection between TMD and cervicogenic HA.
Keywords: Temporomandibular Disorders, Cervicogenic Headache, Cervical spine
Funding acknowledgements: This project was financially supported by a grant from the American Academy of Orofacial Pain (http://www.aaop.org/)
Purpose: To assess the association between TMD and key performance and pain parameters relating to the upper cervical spine.
Methods: Comparative cohort study
A. Comparison of key performance & pain parameters of the upper cervical spine in 74 TMD patients (pain related TMD/intra-articular TMD/mixed TMD) and 42 healthy controls.
B. Assessment of correlations between key cervical spine and temporomandibular pain & performance parameters
C. Assessment of the prevalence and incidence of cervigogenic headache among TMD patients comparing ´pain related´ (n=37), ´intra-articular´ (n=17) , ´mixed´ (n=20) subgroups & healthy controls (n=42).
Results:
A) Significant impairments were found among ´pain related´ & ´mixed´ TMD groups versus ´intra-articular´ & ´healthy´ groups in several key cervical spine performance & pain parameters: Decreased mobility (Extension range of motion, P 0.05; Flexion-rotation test, P˂0.01), activation and performance scores of the deep cervical flexors muscles (P 0.01) and scores of the neck disability index (P˂0.05).
B) Positive correlation was found between temporomandibular average pain parameters (composite pain index) and forward head posture (r=0.35, p=0.005). C) Clear significantly higher prevalence rates of cervicogenic headache were found among ´pain related´ & ´mixed´ TMD (38% & 35% accordingly) versus ´inra-articular´ & ´healthy´ groups (0% & 4% accordingly).
Conclusion(s): Our results support a relevant clinical association between ´pain related´ & ´mixed´ TMD with specific key pain & performance impairments in the upper cervical spine, including high prevalence of cervicogenic headache. ´intra articular´ TMD patients on the other hand demonstrate no significant cervical spine impairments compared to their matched healthy controls.
Implications: Upper cervical spine pain & performance impairments are very likely to be present in people with painful temporomandibular disorders. These impairments may play a role in both etiology and prognosis of TMD patients and therefore should be assessed in all painful TMD patients and managed if presented. Further research in needed for exploring the potential causative connection between TMD and cervicogenic HA.
Keywords: Temporomandibular Disorders, Cervicogenic Headache, Cervical spine
Funding acknowledgements: This project was financially supported by a grant from the American Academy of Orofacial Pain (http://www.aaop.org/)
Topic: Musculoskeletal; Pain & pain management; Musculoskeletal: spine
Ethics approval required: Yes
Institution: Tel Aviv University
Ethics committee: Tel Aviv University ethical committee
Ethics number: No number provided. The approval document is present if needed
All authors, affiliations and abstracts have been published as submitted.
