scholarly journals IDENTIFICATION OF CORRELATION OF TEMPOROMANDIBULAR DYSFUNCTION AND CERVICAL SPINE DISORDERS

2019 ◽  
Vol 15 (1-2) ◽  
pp. 59-64 ◽  
Author(s):  
V.V. Vovk ◽  
V.P. Nespriadko

Relevance. Temporomandibular dysfunction is associated with imbalance of the whole body in static and dynamic. Myofascial Pain in Temporomandibular joint often coexist with chronic neck pain, impacting on posture straightly by changing head position or indirectly by instability of muscles chains. Objective. This study aimed to evaluate frequency of cervical spine disorders (CSD) in case of Temporomandibular dysfunction (TMD), possible correlations between TMD and CSD  in frontal and lateral planes depends on ethiological factors. Materials and methods. The study included 208 patients. Study group consisted of 170 patients with TMD (female – 62,9 %, male – 37,1 %). Contol group consisted of 38 patients. Subjects were examined according to international clinical protocol RDC/TMD, NDI, masticatory,neck motor system were analysed by (BioPak EMG), position of condyles and bone structure – via computed tomography, position and disc reduction – via magnetic resonance imaging, occlusion – via TScan III, cephalometric analysis (frontal, lateral view), statistical analyses with program IBM SPSS Statistic Base v.22. Results. Female more often has temporomandibular dysfunction (62,9 %) than male (37,1 %) among the population. 47,05% were under 30 years. About 98,2 % of patients, presented complaining of Temporomandibular disorder symptoms had neck pain concomitantly and cervical spine disorders in different planes, 44,7% of patients without TMD, but with CSD, value at risk 2,2(95% VaR 1,54-3,13). Moreover 100% of those who did not report pain in the Temporomandibular joints, but presented only with clicking, had reported pain in the neck during physical examination. After examination patients were divided into 4 different clinical groups of TMD depends on ethiology-TMD-neck spinal disability. The largest is combined group – 67,67 % of total patients and is clinical manifested with TMD, spinal neck disorders in several planes. Different dysfunctional conditions between facial skull boned and cervical spine are closely interconnected with each other. Conclusions. There is positive, mild power of correlations between muscles groups trapezius-masseter, trapezius-temporalis (r=0,477, p<0,05), sternocleidomastoideus-temporalis (0,527, p<0,05), sternocleidomastoideus-masseter (0,575, p<0,05), which indicates cooperation between facial muscles and cervical spine muscles. There is changes in cervical spine depends on clinical group: lateral group – C type scoliosis, sagittal – from straightening of cervical lordosis to kyphosis, vertical – «wave» type of cervical spine, combined – combine of pathology in different planes. Initial form of lateral group TMD is characterized as myofascial pain syndrome with specific clinical symptoms, but without condyle and disc displacement, thus it can be as an early prophylactic stage and risk of disc subluxation.

2021 ◽  
Vol 11 (10) ◽  
pp. 145-157
Author(s):  
Jibran Ahmed Khan ◽  
Vipin Kumar Pandey

The main aim of this review article is to identify the evidence-based diagnosis and physiotherapy management of musculoskeletal disorder of cervical spine. Neck pain from cervical spine disorders is the most common cause of musculoskeletal disorders. Neck pain can exist alone or with the presence of upper-extremity symptoms. Key words: Neck Pain, Cervical Spine, Joint mobilization, Massage.


Author(s):  
Om C. Wadhokar ◽  
Deepali S. Patil ◽  
Pratik Phansopkar

Background: Temporomandibular joint dysfunction is one of commonest joint that gets affected in females, studies shows that the altered posture of cervical spine lead to mandibular retrusion and hence in long term leads to Temporomandibular dysfunction, the tightness of sub-occipital muscle leads to pulling of the ligaments around the joint in course causing retrusion or malocclusion. The common symptoms of temporomandibular joint dysfunction includes clicking, reduced mouth opening, headache. Alteration in the function of TMJ leads to poor quality of life of the individual as this joint is involved in basic activities like talking, eating, laughing and kissing. The sub-occipital muscles are the group of muscle extending from spinous process of C2 vertebrae to inferior nuchal line of occipital bone. Tightness of this muscle lead to extension of upper cervical spine and flexion of lower cervical spine. The common causes of temporomandibular dysfunction includes injury to jaw, overuse, inflammatory condition like arthritis and bruxism. Our aim is to find out the efficacy of sub-occipital Myofacial Release versus conventional physiotherapy on functional disability of TMJ. The clinical trial registry-India (CTRI) registration number for this trial is CTRI/2021/05/033493. Methodology: In this study the total of 60 patients with mild to moderate Temporomandibular dysfunction with neck pain were divided into two group one group received MFR and other group received stretching exercises followed by conventional physiotherapy. The treatment was given for two week 5 session in each week. The assessment was done at day one of treatment and the end of first week and at the end of second week. Discussion: This study was done to find out the effectiveness of suboccipital Myofacial release and stretching exercises in mild to moderate Temporomandibular joint dysfunction with neck pain. Conclusion: Conclusion of the study can be made based on the effect of both technique on functional disability in patient with mild to moderate TMD and opt for more specific treatment for rehabilitation of patient with TMD.


Author(s):  
Pierre Langevin ◽  
Philippe Fait ◽  
Pierre Frémont ◽  
Jean-Sébastien Roy

Abstract Background Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2017 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is, however, recommended based only on limited scientific evidence. The benefit of such intervention should therefore be further investigated. Objective To compare the addition of a 6-week individualized cervicovestibular rehabilitation program to a conventional approach of gradual sub-threshold physical activation (SPA) alone in adults with persistent headache, neck pain and/or dizziness-related following a mTBI on the severity of symptoms and on other indicators of clinical recovery. We hypothesize that such a program will improve all outcomes faster than a conventional approach (between-group differences at 6-week and 12-week). Methods In this single-blind, parallel-group randomized controlled trial, 46 adults with subacute (3 to12 weeks post-injury) persistent mTBI symptoms will be randomly assigned to: 1) a 6-week SPA program or 2) SPA combined with a cervicovestibular rehabilitation program. The cervicovestibular rehabilitation program will include education, cervical spine manual therapy and exercises, vestibular rehabilitation and home exercises. All participants will take part in 4 evaluation sessions (baseline, week 6, 12 and 26) performed by a blinded evaluator. The primary outcome will be the Post-Concussion Symptoms Scale. The secondary outcomes will be time to clearance to return to function, number of recurrent episodes, Global Rating of Change, Numerical Pain Rating Scale, Neck Disability Index, Headache Disability Inventory and Dizziness Handicap Inventory. A 2-way ANOVA and an intention-to-treat analysis will be used. Discussion Controlled trials are needed to determine the best rehabilitation approach for mTBI with persistent symptoms such as neck pain, headache and dizziness. This RCT will be crucial to guide future clinical management recommendations. Trial registration ClinicalTrials.gov Identifier - NCT03677661, Registered on September, 15th 2018.


Author(s):  
Eun-Dong Jeong ◽  
Chang-Yong Kim ◽  
Nack-Hwan Kim ◽  
Hyeong-Dong Kim

BACKGROUND: The cranio-cervical flexion exercise and sub-occipital muscle inhibition technique have been used to improve a forward head posture among neck pain patients with straight leg raise (SLR) limitation. However, little is known about the cranio-vertebral angle (CVA) and cervical spine range of motion (CROM) after applying stretching methods to the hamstring muscle. OBJECTIVE: To compare the immediate effects of static stretching and proprioceptive neuromuscular facilitation stretching on SLR, CVA, and CROM in neck pain patients with hamstring tightness. METHODS: 64 subjects were randomly allocated to the static stretching (n1= 32) or proprioceptive neuromuscular facilitation (n2= 32) stretching group. The SLR test was performed to measure the hamstring muscle’s flexibility and tightness between the two groups, with CROM and CVA also being measured. The paired t-test was used to compare all the variables within each group before and after the intervention. The independent t-test was used to compare the two groups before and after the stretching exercise. RESULTS: There were no between-group effects for any outcome variables (P> 0.05). However, all SLR, CVA, and CROM outcome variables were significantly improved within-group (P< 0.05). CONCLUSIONS: There were no between-group effects for any outcome variable; however, SLR, CVA, and CROM significantly improved within-group after the one-session intervention in neck pain patients with hamstring tightness.


Symmetry ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 739
Author(s):  
Neil Tuttle ◽  
Kerrie Evans ◽  
Clarice Sperotto dos Santos Rocha

Tropism, or asymmetry, of facet joints in the cervical spine has been found to be related to degenerative changes of the joints and discs. Clinicians often assume that differences in segmental mobility are related to tropism. The aims of this study were to determine the relationship between asymmetry of facet joints in the sub-axial cervical spine and (1) segmental mobility and (2) spinal levels perceived by therapists to have limited mobility. Eighteen participants with idiopathic neck pain had MRIs of their cervical spine in neutral and at the end of active rotation. Angular movement and translational movement of each motion segment was calculated from 3D segmentations of the vertebrae. A plane was fitted to the facet on each side. Tropism was considered to be the difference in the orientation of the facet planes and ranged from 1 to 30° with a median of 7.7°. No relationships were found between the extent of tropism and either segmental movement or locations deemed to be symptomatic. Tropism in the sub-axial cervical spine does not appear to be related to segmental mobility in rotation or to levels deemed to be symptomatic.


1996 ◽  
Vol 27 (4) ◽  
pp. 729-746
Author(s):  
James Rainville ◽  
Jerry B. Sobel ◽  
Robert J. Banco ◽  
Harvey L. Levine ◽  
Lisa Childs

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Zahra Rezasoltani ◽  
Hanna Ehyaie ◽  
Reza Kazempour Mofrad ◽  
Fatemeh Vashaei ◽  
Reza Mohtasham ◽  
...  

Abstract Objectives Granisetron and lidocaine injections have been used for the management of myofascial pain syndrome. This study was aimed to compare the efficacy of granisetron and lidocaine injections to trigger points of upper trapezius in the management of myofascial pain syndrome. Methods We performed a double-blind randomized clinical trial in an outpatient clinic of physical medicine and rehabilitation at a teaching hospital. A total of 40 patients aged ≥18 with neck pain due to myofascial pain syndrome were included. They had pain for at least one month with the intensity of at least 30 mm on a 100 mm visual analog scale. Each participant received a single dose of 1 mL lidocaine 2% or 1 mg (in 1 mL) granisetron. The solutions were injected into a maximum of three trigger points of the upper trapezius. We instructed all patients to remain active while avoiding strenuous activity for three or four days, and to perform stretch exercise and massage of their upper trapezius muscles. We assessed the patients before the interventions, and one month and three months post-injection. The primary outcome was the Neck Disability Index and the secondary outcome was the Neck Pain and Disability Scale. Results Both interventions were successful in reducing neck pain and disability (all p-values <0.001). However, the neck pain and disability responded more favorably to lidocaine than granisetron (p=0.001 for Neck Disability Index, and p=0.006 for Neck Pain and Disability Scale). No significant side-effect was recognized for both groups. Conclusions Both lidocaine and granisetron injections to trigger points are effective and safe for the management of the syndrome and the benefits remain at least for three months. However, lidocaine is more effective in reducing pain and disability. The injections are well-tolerated, although a transient pain at the site of injections is a common complaint. One mL of lidocaine 2% is more effective than 1 mg (in 1 mL) granisetron for injecting into the trigger points of the upper trapezius in myofascial pain syndrome.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 463.2-464
Author(s):  
A. Alawamy ◽  
M. Hassanien ◽  
E. Talaat ◽  
E. Kamel

Background:Rheumatoid arthritis is a common type of autoimmune arthritis characterized by chronic inflammation. Cervical spine is often affected specially in long lasting diseaseObjectives:Evaluate efficacy of Third occipital nerve Radiofrequency under fluoroscopic guidance to treat refractory cervicogenic headache in RA patients.Methods:The current study was revised and approved from the local ethical committee of Faculty of Medicine; Assiut University, then registered in the clinical trials under the number ofNCT03852355. Inclusion criteria included, Patients who fulfilled the American College of Rheumatology (ACR) (2010) criteria for RA and suffering from upper neck pain and/or headache due to bilateral 3rd occipital nerve involvement, excluding other local cervical spine pathologies was confirmed by MRI and previously failed conservative treatment for at least three months prior to enrollment. Sixty adult patients were randomly assigned to one of the two studied groups Group 1 (RF, n = 30), received bilateral Third occipital nerve Radiofrequency under fluoroscopic guidance or Group 2 (control group, n = 30), received oral prednisolone 10 mg/day. The two groups were then followed-up with neck disability index (NDI), nocturnal neck pain VAS score and headache score every two weeks for three months. Sleep disturbance, sleep disability index were reassessed six months post intervention. Post interventional assessment was done by pain physician who were kept blind to the grouping process.Results:Neck disability index (1ry outcome), Nocturnal pain VAS, and severity of headache showed significant differences during the whole post-interventional study period. The patients in RF group demonstrated significant improvement of pain in comparison to baseline value over the whole six months with p-value < 0.001 as regard to the fore-mentioned three parameters. On the other aspect, the control group patients showed significant improvement in comparison to its baseline value after the 2nd, 12th and 24th weeks only as follows: (0.001,0.003, 0.003 for the NDI) (p values of 0.02,0.01, 0.01 for the nocturnal pain VAS), (0.001 0.009, 0.005 for the headache VAS severity.Conclusion:Radiofrequency of 3rd occipital nerve is effective in treatment of refractory cervicogenic headache in RA.Disclosure of Interests: :None declared


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