Cervical-scapular muscles strength and severity of temporomandibular disorder in women with mechanical neck pain

Fernanda Pasinato,Clarissa C Santos-Couto-Paz,Juliana Bordin,Eliane C R Corrêa,Juliana Alves Souza

doi:10.1590/0103-5150.029.002.ao05

Fernanda Pasinato, Clarissa C Santos-Couto-Paz + Show 3 more

Open Access

https://doi.org/10.1590/0103-5150.029.002.ao05

Copy DOI

Abstract

Abstract Introduction: Changes in cervical muscle function have been observed in patients with neck pain (NP) and TMD. However, the relationship between TMD severity and neck muscle strength in the presence/absence of NP is unknown. Objective: To determine the prevalence of TMD in women with and without mechanical NP and assess the cervical-scapular muscle strength and its association with TMD severity. Methods: Fifteen volunteers without neck pain (CG) and 14 women with mechanical neck pain (NPG) took part and were selected by the Neck Disability Index. The diagnosis and severity of TMD were determined by the Research Diagnostic Criteria for TMD and Temporomandibular Index (TI), respectively. The strength of the upper trapezius muscle, and cervical flexor and extensor muscles was measured by digital hand dynamometer. Results: 64.5% of women with NP and 33.3% without NP were diagnosed with TMD (p = 0.095). The NPG showed lower strength of the cervical flexor (p = 0.044) and extensor (p=0.006) muscles, and higher TI (p = 0.038) than in the CG. It was also verified moderate negative correlation between TI and the strength of dominant (p = 0.046, r = -0.547) and non-dominant (p = 0.007, r = -0.695) upper trapezius, and cervical flexors (p = 0.023, r = -0.606) in the NPG. Conclusion: There was no difference in the prevalence of TMD in women with and without NP. However, women with NP have lower cervical muscle strength - compared to those without NP - which was associated with greater severity of TMD. Thus, in women with NP associated with TMD, it is advisable to assess and address the severity of this dysfunction and identify the cervical-scapular muscles compromise.

Highlights

Changes in cervical muscle function have been observed in patients with neck pain (NP) and TMD
The purpose of this study is to provide information to help understand the details about the interaction between the cervical spine and the temporomandibular joint (TMJ), taking into account the role of TMD severity and the cervical-scapular muscles strength
Twenty-nine women, aged 21 to 42, were assessed and allocated in two groups according to the neck disability index (NDI) results [29, 30]: NPG – Mechanical Neck Pain Group (n = 14), comprising women with neck pain complaint for more than three months [5] and cervical disability con irmed by the NDI score > 4; CG – Control Group (n = 15), comprising volunteers without neck pain complaint, with NDI score ≤ 4

Summary

Introduction

Changes in cervical muscle function have been observed in patients with neck pain (NP) and TMD. It has been shown that individuals with chronic neck pain exhibit structural and functional changes including weakness and cervical lexor and extensor muscles imbalance [5,6,7,8], a decrease in the cervical range of motion, as well as proprioceptive de icits and compromise of postural control [9]. Those changes are thought to be assigned to the re lex inhibition associated with pain, causing damage to the muscular function [10] and favoring the chroni ication of mechanical neck pain [6, 11]. The biomechanical and neuroanatomic relationship between the cervical spine and the stomatognathic system has been veri ied in clinical and experimental studies [12,13,14], the link between the dysfunctions affecting these systems remains in dispute

Objectives

Methods

Results

Conclusion