Cervical pain in patients with temporomandibular disorders
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Abstract
Objective
Temporomandibular disorders are a heterogeneous group of musculoskeletal diseases, which involve the temporomandibular joints, the muscles of mastication as well as associated tissues.
Excluding the forms attributable to specific or systemic causes, temporomandibular dysfunctions can be ascribed to psychosocial and functional factors, and cervical pain might be included among the various symptoms described by patients with temporomandibular pathologies. The aim of the present study was to investigate the prevalence of non-specific cervical pain in a group of patients with temporomandibular disorders, also considering the prevalence of cervical pain in various secondary diagnostic groups (muscular, joint and mixed diseases).
Materials and Methods
We selected a sample of patients examined for craniofacial pain or mandibular functional problems in an outpatient dental practice focused on Clinical Gnatology and orofacial pains.
After applying inclusion and exclusion criteria, the final sample consisted of 238 adult patients with an average age of 43±14 years and 79.4% of female gender. Therefore, the prevalence of cervical pain in our study sample was investigated, also considering the prevalence in the different secondary diagnostic groups (test chi2; α =.05).
Results
In our study sample the prevalence of cervical pain was 60% (p<0.05). Gender and age were not associated with reported cervical pain (p>0.05). The prevalence of cervical pain in the various secondary diagnostic groups ranged between 45% and 71.4%, without any statistically significant difference (p>0.05).
Discussion
According to various literature studies, in patients with temporomandibular dysfunctions, we found a cervical pain prevalence greater than half of the cases.
Despite the traditional convinctions of an association between cervical pain and temporomandibular disorders of muscular origin, we found a prevalence of cervical pain statistically equally distributed in the muscular, joint and mixed pathologies.
Gender, age and site of the disorder were not variables probably involved in the relationship between temporomandibular diseases and cervical pain whereas an apparently more adequate concomitant role of psychosocial or functional variables between the two phenomena was hypotesized.
Conclusion
Cervical pain is a frequently reported symptom in patients with temporomandibular disorders.
Probably gender, age and secondary diagnosis of temporomandibular dysfunction are not variables involved in the association, however conclusive data are not available. The multifactorial cause of temporo-mandibular pathologies with predisposing, triggering and perpetuating factors suggests a conservative and multimodal gnathological management.
Key – words: Temporomandibular Disorders, Cervical Pain, Neck Pain, Dentistry.
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