Influence of the Temporomandibular Joint on Range of Motion of the Hip Joint in Patients With Complex Regional Pain Syndrome
Received 21 November 2008; received in revised form 13 January 2009; accepted 9 March 2009.
Abstract
Objective
This study evaluated if patients with complex regional pain syndrome (CRPS) would have an increase in range of motion (ROM) after myofascial release and a similar ROM decrease after jaw clenching, whereas in healthy subjects these effects would be minimal or nonexistent.
Methods
Documentation of patients with CRPS (n = 20) was established using the research diagnostic criteria for CRPS, questionnaires, average pain intensity for the past 4 weeks, and the temporomandibular index (TMI). Healthy subjects (n = 20, controls) also underwent the same testing. Hip ROM (α angle) was measured at 3 time points as follows: baseline (t1), after myofascial release of the temporomandibular joint (t2), and after jaw clenching for 90 seconds (t3). Comparison of the CRPS and control groups was made using t tests.
Results
Mean TMI total score and mean pain reported for the last 4 weeks were significantly different between the 2 groups (P < .0005). Hip ROM at t1 was always slightly higher compared to t3, but t2 was always lower in value compared to t1 or t3 for both groups. The differences of all hip ROM values between the groups were significant (P < .0005). Moreover, the difference between t1 or t3 and t2 was significantly different within the CRPS group (t1 = 48.7°; t2 = 35.8°; P < .0005).
Conclusions
The results suggest that temporomandibular joint dysfunction plays an important role in the restriction of hip motion experienced by patients with CRPS, which indicated a connectedness between these 2 regions of the body.
aDepartment of Rehabilitation Medicine, Hanover Medical School, Hanover, Germany
bDepartment of Neurology, Friedrich Baur Institute, Ludwig Maximilians University, Munich, Germany
cDepartment of Anesthesiology, Pain Clinic, Hanover Medical School, Hanover, Germany
Submit requests for reprints to: Michael J. Fischer, MD, Department of Rehabilitation Medicine (OE8300), Hanover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hanover, Germany
ABSTRACT