• Physical Therapy Rehabilitation Science
• /
• v.9 no.4
• /
• pp.215-221
• /
• 2020

Objective: Tension-type headaches usually occur with temporomandibular disorder, which increases the risk of the chronic tension-type headaches. This study was conducted to investigate the effect of additional temporalmandibular therapy compared to cerivcal joint therapy for tension-type headaches with pericranial tenderness. Design: Randomized controlled trial. Methods: Forty-one patients with chronic tension-type headaches and pericranial tenderness were randomized into the 3 groups, such as the temporomandibular joint therapy group (TMJT group, n=14), cervical manual therapy group (CMT group, n=14) and conservative therapy group (CT group, n=13). All patients were assessed at baseline and after each intervention during the three sessions. The participants in the TMJT group received the temporomadibular joint treatment and cervical manual therapy for 30 minutes, once a week, for 3 weeks. The participants in the CMT group received the cervical manual therapy, and those in the CT group received modalities during same time period. The outcome measurements used were the intensity of headaches measured on the Visual Analogue Scale (VAS), quality of life measured with the Headache Impact Test (HIT-6), and function of the cervical spine using the Neck Diability Index (NDI). Results: The TMJT group that received temporomandibular joint treatment and cervical manual therapy showed a significant decrease in VAS, HIT-6, and NDI compared with the other 2 groups (p<0.05). Conclusions: This study suggected that temporomandibular joint treatment combined with cervical manual therapy was more effective for the chronic tension-type headaches with pericranial tenderness than the usual cervical therapy alone.

• Journal of Oral Medicine and Pain
• /
• v.35 no.2
• /
• pp.123-133
• /
• 2010

The purpose of this study is to investigate Tension-type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder among Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score using RDC/TMD Axis II. Eighty five patients who visited the Kyung Hee University Dental Hospital were diagnosed as Tension-type headache associated with pericranial tenderness(n=48) and Headache attributed to temporomandibular joint disorder(n=37) by the International Classification of Headache Disorders, 2nd Edition, and were administered the Korean versions of the RDC/TMD Axis II- Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score. Then it was analyzed statistically by SPSS(ver. 10.0). T-test, The Wilcoxon-signed rank test and Mann-Whitney U test (p<0.05) were used. There were no significant differences in Characteristic pain index, Disability points, Chronic pain grade, Depression index, Nonspecific physical symptoms (pain items included), Nonspecific physical symptoms (pain items excluded), Jaw disability score between two groups. Tension type headache associated with pericranial tenderness and Headache attributed to temporomandibular joint disorder showed similar Axis II feature. Tension-type headache associated with pericranial tenderness may be related to Headache attributed to temporomandibular joint disorder.

• Journal of Oral Medicine and Pain
• /
• v.35 no.3
• /
• pp.213-219
• /
• 2010

Aim: The aims of this study were to survey the frequency of pain to palpation of the occipitofrontalis muscle in a TMD patient group, and to identify patients showing pain to palpation of the occipitofrontalis muscle that is also consistent with patients' headache symptom. Methods: A total of 218 TMD patients ($32.0{\pm}13.1$ years) participated in this study. Patients' symptoms, including headache, were surveyed by questionnaire. Temporomandibular joints, jaw muscles, and pericranial muscles including the occipitofrontalis muscle were examined with digital palpation. Pain to palpation (i.e. tenderness) was scored from 0 to 3 according to the patients' response, and frequencies were calculated of pain to palpation scores for each site of the pericranial muscles. Results: Twelve patients among 218 TMD patients (5.5%) showed pain to palpation (scores of 1, 2) on the occipitalis or frontalis sites, and seven patients (3.2%) had moderate pain (a score of 2) to palpation. Among 218 TMD patients, there was only one patient whose primary symptomatic site of headache corresponded with the result of pain to palpation of the occipitofrontalis muscle. Conclusion: It can be concluded that examination with palpation of the occipitofrontalis muscle could be considered in the evaluation of TMD patients' headache symptom when other factors have been ruled out.

• Journal of Oral Medicine and Pain
• /
• v.31 no.4
• /
• pp.355-364
• /
• 2006

Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.