Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial.
Cervicogenic headache (CGH) might involve clinical signs such as restricted cervical range of motion (ROM) and pain on cervical palpation. Some feel that the temporomandibular joint (TMJ) may contribute to CGH, based on the close proximity and mutual influence of the two regions.
This study aimed to determine whether treatment for TMJ dysfunction, in addition to cervical manual therapy, (CMT) was more effective than CMT alone.
Forty-three participants with headache for greater than 3 months, signs of CGH and of TMJ dysfunction were randomly assigned to a CMT-only group or a TMJ treatment plus CMT group.
Six treatments were given over 3 months. Assessment (cervical ROM and upper cervical palpation) was conducted initially, at treatment conclusion and after 6 months.
The group that received TMJ treatment in addition to CMT showed significant reduction in all aspects of cervical impairment after 6 treatments. This lasted at the 6-month assessment. The improvement in cervical ROM occurred mostly during the treatment period and only in the TMJ treatment plus CMT group. This did not occur in the CMT-only group.
The moral of this story: Look for features of TMJ dysfunction when examining patients with headache and if dysfunction is present, direct treatment to the TMJ. > From: Von Piekartz & Hall. Man Ther 18 (2013) 345-350. All rights reserved to Elsevier Ltd.
The Pubmed summary of the article can be found here.