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Yu Ming L1,2, Yang Hua L1,3,4, Wan Ju L1,5, Bo Ru H1,6
1School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, 2Xin Tai General Hospital, Department of Physical Therapy, Xindian, Taiwan, 3Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan, 4Division of Physical Therapy, Department of Physical Medicine and Rehabilitation, Chiayi Chang Gung Memorial Hosipital, Chiayi, Taiwan, 5Health Checkup Center, Taiwan Adventist Hospital, Taipei, Taiwan, 6Landseeds Hospital, Taoyuan, Taiwan
Background: The temporomandibular joint (TMJ) is an important structure for eating, chewing, and talking. The main symptoms of temporomandibular joint disorders (TMD) are facial pain, joint noise, and abnormal mandibular movements. Patients with TMD may also experience neck pain symptoms. However, TMJ performance and TMD classification in patients with neck pain is still not clear.
Purpose: The purpose of this study was to investigate the performance of TMJ as well as the severity and classification of TMD in patients with neck pain using clinical functional evaluation.
Methods: This was an observational study design. We recruited participants with chronic neck pain aged between 20 and 80 years. The Visual Analogue Scale (VAS) ruler was used to assess the intensity of neck pain and the Neck Disability Index (NDI) was used to assess the severity of neck disability. We used the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) to assess the severity and classification of TMDs and mandibular function. To assess pain sensitivity, we used the Pressure Pain Threshold (PPT) in the craniocervical region. The dynamic masticatory endurance test was used to assess masticatory endurance. We conducted descriptive statistical analysis, including frequency, percentage, mean, and standard deviation. One way ANOVAs and independent t test were used to compare differences in assessment measures among groups for DC/TMD results under TMD classification. We performed a correlation analysis of neck disability, jaw disability, and performance of TMJ.
Results: Fifty-three participants who complained of neck pain for more than three months were recruited. All participants had moderate neck pain and mild neck disability (mean NDI score 8.4±4.6), of whom 38 had mixed type of TMD (71.7%). In the TMD group, a significantly higher percentage expressed facial pain, joint noise, and jaw dysfunction than in the group without TMD. The PPT results showed that the muscles in the craniocervical region were significantly less sensitive in the TMD group, and were not affected by chewing dominance and limited mouth opening. We found a low to moderate correlation of neck disability and jaw disability with TMJ performance.
Conclusion(s): Adults with moderated chronic neck pain and mild disability were accompanied by articular and painful types of TMD. In addition to altered chewing endurance, adults with chronic neck pain accompanied by TMD also had affected mandibular function and changes in PPT.
Implications: The findings of our study provide the reference of assessment of temporomandibular joint in patients with neck pain. Strengthened the evidence between temporomandibular disorder and neck pain. Moreover, suggest clinicians the neck pain in patients with TMD could be the attention and management.
Keywords: Temporomandibular Disorders, Neck Pain, Clinical Assessment
Funding acknowledgements: The supplies and tools for this study supported by musculoskeletal laboratory in Chang Gung University.
Purpose: The purpose of this study was to investigate the performance of TMJ as well as the severity and classification of TMD in patients with neck pain using clinical functional evaluation.
Methods: This was an observational study design. We recruited participants with chronic neck pain aged between 20 and 80 years. The Visual Analogue Scale (VAS) ruler was used to assess the intensity of neck pain and the Neck Disability Index (NDI) was used to assess the severity of neck disability. We used the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) to assess the severity and classification of TMDs and mandibular function. To assess pain sensitivity, we used the Pressure Pain Threshold (PPT) in the craniocervical region. The dynamic masticatory endurance test was used to assess masticatory endurance. We conducted descriptive statistical analysis, including frequency, percentage, mean, and standard deviation. One way ANOVAs and independent t test were used to compare differences in assessment measures among groups for DC/TMD results under TMD classification. We performed a correlation analysis of neck disability, jaw disability, and performance of TMJ.
Results: Fifty-three participants who complained of neck pain for more than three months were recruited. All participants had moderate neck pain and mild neck disability (mean NDI score 8.4±4.6), of whom 38 had mixed type of TMD (71.7%). In the TMD group, a significantly higher percentage expressed facial pain, joint noise, and jaw dysfunction than in the group without TMD. The PPT results showed that the muscles in the craniocervical region were significantly less sensitive in the TMD group, and were not affected by chewing dominance and limited mouth opening. We found a low to moderate correlation of neck disability and jaw disability with TMJ performance.
Conclusion(s): Adults with moderated chronic neck pain and mild disability were accompanied by articular and painful types of TMD. In addition to altered chewing endurance, adults with chronic neck pain accompanied by TMD also had affected mandibular function and changes in PPT.
Implications: The findings of our study provide the reference of assessment of temporomandibular joint in patients with neck pain. Strengthened the evidence between temporomandibular disorder and neck pain. Moreover, suggest clinicians the neck pain in patients with TMD could be the attention and management.
Keywords: Temporomandibular Disorders, Neck Pain, Clinical Assessment
Funding acknowledgements: The supplies and tools for this study supported by musculoskeletal laboratory in Chang Gung University.
Topic: Musculoskeletal: spine; Musculoskeletal: spine; Musculoskeletal
Ethics approval required: Yes
Institution: Linkou Chang Gung Memorial Hospital
Ethics committee: Chang Gung Medical Foundation Institutional Review Board
Ethics number: 201800445B0
All authors, affiliations and abstracts have been published as submitted.
