Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: A randomized controlled trial
Open accessAbstract
There is evidence that temporomandibular disorder (TMD) may be a contributing factor to cervicogenic headache (CGH), in part because of the influence of dysfunction of the temporomandibular joint on the cervical spine. The purpose of this randomized controlled trial was to determine whether orofacial treatment in addition to cervical manual therapy, was more effective than cervical manual therapy alone on measures of cervical movement impairment in patients with features of CGH and signs of TMD. In this study, 43 patients (27 women) with headache for more than 3-months and with some features of CGH and signs of TMD were randomly assigned to receive either cervical manual therapy (usual care) or orofacial manual therapy to address TMD in addition to usual care. Subjects were assessed at baseline, after 6 treatment sessions (3-months), and at 6-months follow-up. 38 subjects (25 female) completed all analysis at 6-months follow-up. The outcome criteria were: cervical range of movement (including the C1-2 flexion-rotation test) and manual examination of the upper 3 cervical vertebra. The group that received orofacial treatment in addition to usual care showed significant reduction in all aspects of cervical impairment after the treatment period. These improvements persisted to the 6-month follow-up, but were not observed in the usual care group at any point. These observations together with previous reports indicate that manual therapists should look for features of TMD when examining patients with headache, particularly if treatment fails when directed to the cervical spine.
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Pooling results of 2 studies, MT targeted to the orofacial region or in combination with cervical treatment was better than home exercises for the jaw and neck alone or treatment to cervical spine alone for improving mouth opening.
“Pooling the results of the 2 studies 75,105,106 with similar interventions, outcomes, and diagnoses, we found that MT targeted to the orofacial region or in combination with cervical treatment was better than home exercises for the jaw and neck alone or treatment to cervical spine alone for improving mouth opening.”
From Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis (2016) · cites this paper as [105]
The Intervention section confirms that this trial compared orofacial treatment, usually combined with cervical treatment, against cervical treatment alone. But the Results section reports improvement in cervical movement, while restricted mouth opening is described as a baseline sign; our copy does not report improvement in mouth opening. The pooling result is the citing authors’ own finding, not a finding attributed to this trial alone. (LLM, conf=0.85)
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- Authors
- von Piekartz, H., & Hall, T.
- Affiliations
- Curtin University (AU)
- ORCID
- Hall, Toby
- Venue
- Manual Therapy
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 18
- Issue
- 4
- Pages
- 345-350
- ISSN
- 1356-689X (ISSN-L)
- OpenAlex
- W2099477155
- Cited by
- 74
- References
- 47
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 3 · 2023: 9 · 2022: 6 · 2021: 5 · 2020: 8 · 2019: 8 · 2018: 4 · 2017: 5 · 2016: 8 · 2015: 5 · 2014: 2 · 2013: 2
- FWCI
- 9.12
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Manual Therapy (publishedVersion)
- PubMed (publishedVersion)
- eSpace (Curtin University) (submittedVersion)
- Library Osnabrück University (Hochschule Osnabrück) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Migraine and Headache Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Keywords
- cervicogenic headache, temporomandibular disorders, headache, cervical spine
- MeSH terms
- Adolescent, Adult, Aged, Analysis of Variance, Cervical Vertebrae, Female, Humans, Male, Middle Aged, Pain Measurement, Severity of Illness Index, Temporomandibular Joint Disorders, Range of Motion, Articular, Treatment Outcome, Neck Pain, Recovery of Function, Myofunctional Therapy, Manipulation, Spinal, Musculoskeletal Manipulations, Post-Traumatic Headache, Young Adult
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