• Izumi Makino, Young-Chang P Arai, Shuichi Aono, Kazuhiro Hayashi, Atsuko Morimoto, Makoto Nishihara, Tatsunori Ikemoto, Shinsuke Inoue, Miyuki Mizutani, Takako Matsubara, and Takahiro Ushida.
• Multidisciplinary Pain Centre, School of Medicine, Aichi Medical University, Nagakute, Japan.
• Pain Pract. 2014 Jun 1;14(5):413-8.

PurposeApparent organic abnormalities are sometimes not identified among patients suffering from chronic pain in the craniocervical region. In some cases, parafunctional activities (PAs) are recognized. PAs are nonfunctional oromandibular activities that include jaw clenching and bruxism, but are considered as factors that contribute to craniomandibular disorders (CMDs). It is now recognized that PAs and CMDs influence musculoskeletal conditions of the upper quarter. Exercise therapy (ET) to improve jaw movement and psychological intervention (PI) to reduce PAs are useful for PAs and CMDs. We hypothesized that ET and PI would be effective for craniocervical pain without organic abnormalities.MethodsThirty-nine subjects suffering from craniocervical chronic pain were allocated into 3 groups: The control group received only pharmacological treatment; the ET group received jaw movement exercise (JME); and the ET-PI group received JME and PI. Pain and jaw movement were evaluated using a numerical rating scale (NRS).ResultsAfter interventions, the NRS scores were significantly lower in the ET-PI group, compared with those in the other groups. Jaw movement improved 100% in the ET group, 92% in the ET-PI group, and 0% in the control group.ConclusionA combination of jaw exercise and psychological intervention to reduce parafunctional activities is more effective than jaw exercise alone for the improvement of craniocervical pain without apparent organic abnormalities.© 2013 World Institute of Pain.

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