Effect of treatment of temporomandibular disorders (TMD) in patients with cervicogenic headache

TY - JOUR

T1 - Effect of treatment of temporomandibular disorders (TMD) in patients with cervicogenic headache

T2 - a single-blind, randomized controlled study

AU - von Piekartz, Harry

AU - Lüdtke, Kerstin

PY - 2011/1/1

Y1 - 2011/1/1

N2 - The present study was comprised of 43 patients (16 men) with cervicogenic headaches for over three months, diagnosed according to the International Classification of Diagnostic Criteria of Headaches (ICDH-II). The patients were randomly assigned to receive either manual therapy for the cervical region (usual care group) or additional manual therapy techniques to the temporomandibular region to additionally influence temporomandibular disorders (TMD). All patients were assessed prior to treatment, after six sessions of treatment, and at a six-month follow-up. The outcome criteria were: intensity of headaches measured on a colored analog scale, the Neck Disability Index (Dutch version), the Conti Anamnestic Questionnaire, noise registration at the mandibular joint using a stethoscope, the Graded Chronic Pain Status (Dutch version), mandibular deviation, range of mouth opening, and pressure/pain threshold of the masticatory muscles. The results indicate in the studied sample of cervicogenic headache patients, 44.1% had TMD. The group that received additional temporomandibular manual therapy techniques showed significantly decreased headache intensities and increased neck function after the treatment period. These improvements persisted during the treatment-free period (follow-up) and were not observed in the usual care group. This trend was also reflected on the questionnaires and the clinical temporomandibular signs. Based on these observations, we strongly believe that treatment of the temporomandibular region has beneficial effects for patients with cervicogenic headaches, even in the long-term.

AB - The present study was comprised of 43 patients (16 men) with cervicogenic headaches for over three months, diagnosed according to the International Classification of Diagnostic Criteria of Headaches (ICDH-II). The patients were randomly assigned to receive either manual therapy for the cervical region (usual care group) or additional manual therapy techniques to the temporomandibular region to additionally influence temporomandibular disorders (TMD). All patients were assessed prior to treatment, after six sessions of treatment, and at a six-month follow-up. The outcome criteria were: intensity of headaches measured on a colored analog scale, the Neck Disability Index (Dutch version), the Conti Anamnestic Questionnaire, noise registration at the mandibular joint using a stethoscope, the Graded Chronic Pain Status (Dutch version), mandibular deviation, range of mouth opening, and pressure/pain threshold of the masticatory muscles. The results indicate in the studied sample of cervicogenic headache patients, 44.1% had TMD. The group that received additional temporomandibular manual therapy techniques showed significantly decreased headache intensities and increased neck function after the treatment period. These improvements persisted during the treatment-free period (follow-up) and were not observed in the usual care group. This trend was also reflected on the questionnaires and the clinical temporomandibular signs. Based on these observations, we strongly believe that treatment of the temporomandibular region has beneficial effects for patients with cervicogenic headaches, even in the long-term.

KW - Adolescent

KW - Adult

KW - Aged

KW - Facial Pain

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Masseter Muscle

KW - Middle Aged

KW - Neck

KW - Pain Measurement

KW - Pain Threshold

KW - Physical Therapy Modalities

KW - Post-Traumatic Headache

KW - Range of Motion, Articular

KW - Single-Blind Method

KW - Sound

KW - Temporal Muscle

KW - Temporomandibular Joint

KW - Temporomandibular Joint Disorders

KW - Time Factors

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1179/crn.2011.008

DO - 10.1179/crn.2011.008

M3 - SCORING: Journal article

C2 - 21370769

VL - 29

SP - 43

EP - 56

JO - CRANIO

JF - CRANIO

SN - 0886-9634

IS - 1

ER -