Clinical tests in distinguishing between persons with or without craniomandibular or cervical spinal pain complaints

Abstract

The recognition of a craniomandibular or cervical spinal pain is usually based upon the pain complaint of the patient, reported during an oral history, and the pain responses provoked in a clinical examination. Often used clinical tests are palpation, and function tests like dynamic/static tests or active movements. The relative importance of these tests for the recognition of the musculoskeletal pain is important. Therefore, it was the aim of the present study to determine which test, or combination of tests, best discriminates between persons with or without craniomandibular and/or cervical spinal pain complaints. Two hundred and fifty persons participated. From each person, a standardized oral history was taken. Then, in a randomized order and using a blind design, physical examinations of the craniomandibular system and of the neck were performed. Forward stepwise logistic regression analyses showed that the dynamic/static tests discriminated better between persons with and without pain complaints than the other tests did. In conclusion, in studies to the coexistence of craniomandibular and cervical spinal pain, it may be a good choice to base the recognition of these disorders on the pain complaints reported in the oral history which are verified by the pain response of the dynamic/static tests.

Influence of craniomandibular and cervical pain on the activity of masticatory muscles in individuals with Temporomandibular Disorder

“…Temporomandibular disorder (TMD) and cervical spine dysfunction include clinical problems in the musculoskeletal structures of the masticatory system and the cervical spine (1) . Clinical manifestations such as pain, joint noises, and irregular or impaired mandibular function are frequent.…”

The role of the clinical examination in management of temporo-mandibular and cervical disorders

“…of maximum rotation and flexing/extension movement 29 Visscher 29 has made these statements about cervical movements: -during active and passive movements kappa value is between 56 and 89; -during dynamic and static tests against resistance the kappa value is between .43 and .60; -sensitivity = 70.7; -specificity = 69.7.…”

“…By using dynamic and static tests, orthodontists can distinguish between health patients and those suffering from temporo-mandibular disorders in muscular and articular palpation 29 .…”

“…-trapezius: at the center of different quadrants 29 and in its fleshy portion at the level of the cervico-scapular angle 19 . The examiner palpates a large part of the extended muscle.…”

“…These require the cooperation of patients who must inform the examiner after each maneuver how the sensations they experienced should be scored on a visual analog scale or on a verbal scale 18,29 .…”