Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 5 , Pages 364-371, June 2009

Influence of the Temporomandibular Joint on Range of Motion of the Hip Joint in Patients With Complex Regional Pain Syndrome

  • Michael J. Fischer, MD

      Affiliations

    • Department of Rehabilitation Medicine, Hanover Medical School, Hanover, Germany
    • Department of Neurology, Friedrich Baur Institute, Ludwig Maximilians University, Munich, Germany
    • Corresponding Author InformationSubmit requests for reprints to: Michael J. Fischer, MD, Department of Rehabilitation Medicine (OE8300), Hanover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hanover, Germany
  • ,
  • Kathrin Riedlinger, MD

      Affiliations

    • Department of Neurology, Friedrich Baur Institute, Ludwig Maximilians University, Munich, Germany
  • ,
  • Christoph Gutenbrunner, MD, PhD

      Affiliations

    • Department of Rehabilitation Medicine, Hanover Medical School, Hanover, Germany
  • ,
  • Michael Bernateck, MD

      Affiliations

    • Department of Anesthesiology, Pain Clinic, Hanover Medical School, Hanover, Germany

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.

Key Indexing Terms: Complex Regional Pain Syndromes, Temporomandibular Joint Disorders, Range of Motion, Articular, Hip

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PII: S0161-4754(09)00109-2

doi:10.1016/j.jmpt.2009.04.003

Journal of Manipulative and Physiological Therapeutics
Volume 32, Issue 5 , Pages 364-371, June 2009