• Josiah D Sault.
• a Department of Outpatient Physical Therapy , University of Illinois Hospital and Health Sciences System , Chicago , IL , USA .
• Cranio. 2016 Mar 1; 34 (2): 124-32.

Objective And ImportanceTemporomandibular disorders (TMD) encompass a variety of dysfunction of the maxillofacial region. A strong relationship between TMD and cervical spine pain exists, and widespread hyperalgesia is common in TMD. This case describes the management and reduction in regional hyperalgesia in a patient with chronic TMD.Clinical PresentationA 23-year-old female with a 10-year history of tinnitus and bilateral (B) jaw pain, and 5-year history of intermittent neck pain, presented with pain, which could reach 10/10 on the numeric pain rating scale, locking, tightness and restricted eating habits. Cervical motion testing did not reproduce her jaw pain. Her mouth opening (MO) and B temporomandibular joint (TMJ) accessory glides were limited and painful. Accessory glides at the upper cervical facet joints reproduced her jaw pain. Pressure pain thresholds (PPT) at her B masseters and thenar eminences at the hand were diminished, indicating hyperalgesia.InterventionTreatment included passive mobilizations at her TMJs and cervical spine. Home exercises included self-mobilization of her TMJs and neck. In six sessions, her MO improved from 30 to 45 mm and average pain improved from 4/10 to 0/10. The jaw pain and function questionnaire improved from 16/52 to 5/52. PPTs at her right/left masseter and thenar eminence improved from 140/106 and 221/230 kPa to 381/389 and 562/519 kPa, respectively.ConclusionThis case described the treatment and reduction of upper extremity hyperalgesia of a patient with chronic jaw and neck pain. Manual therapy may be a valuable intervention in the treatment of chronic TMD with distal hyperalgesia.

6 keywords...

hide…