Retrospective study to identify trigeminal–cervical ocular referred pain as a new causative entity of ocular pain
Open accessAbstract
Purpose: To determine the prevalence and clinical characteristics of trigeminal–cervical (TC) ocular referred pain. Methods: A retrospective study of 1,680 patients seen during 2002–2010 was performed in an ocular surface specialty center to identify patients with or without TC pain defined as ocular pain with ipsilateral trigger points located at the occipital region. Patients with refractory TC pain despite topical anesthetics and conventional treatments received interventional injection to each trigger point. Results: A total of 81 (4.8%) patients (study group) with TC pain and 241 patients (control group) without TC pain were identified out of the 1,680 patients over an 8 year period. There was no difference in age, gender, prior surgeries, medications, non-pain symptoms, pain laterality, and concomitant ocular diseases between the 2 groups. Multivariate regression analysis showed that patients with TC pain had a significant correlation with persistent deep ocular pain, ipsilateral trigger points ( f 2 =99, p <0.001) but not headaches ( f 2 =0.09, p =0.5). Injection at the trigger points achieved complete or partial pain resolution with a low recurrence rate in 43 of 45 (96%) patients with TC pain. Conclusion: TC pain defined herein may be a different entity of ocular pain and can indeed be differentiated from other ocular pain by the referral character so that one may avoid mislabeling it as undetermined or as a reason to unnecessarily overtreat concomitant ocular diseases. Keywords: headache, new ocular pain, referred pain, trigeminal–cervical, trigger point, occipital neuralgia
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A limited number of randomized controlled trials evaluate any particular physical therapy intervention.
“Few systematic reviews evaluate the efficacy of physical therapy interventions, and a limited number of randomized controlled trials (RCTs) evaluate any particular physical therapy intervention.13,21,22”
From The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis (2023) · cites this paper as [21]
The Results (Treatment) describe conservative treatments and trigger-point injections for ocular pain, while the Discussion identifies this study as retrospective and calls for future comparative studies. Neither section addresses how many randomized controlled trials evaluate particular physical therapy interventions; searches for randomized trials and physical therapy interventions found no such passage. Page numbers were not provided in our copy. (LLM, conf=0.78)
Experimental — accuracy not yet measuredFew systematic reviews evaluate the efficacy of physical therapy interventions.
“Few systematic reviews evaluate the efficacy of physical therapy interventions, and a limited number of randomized controlled trials (RCTs) evaluate any particular physical therapy intervention.13,21,22”
From The Effect of Upper Cervical Mobilization/Manipulation on Temporomandibular Joint Pain, Maximal Mouth Opening, and Pressure Pain Thresholds: A Systematic Review and Meta-Analysis (2023) · cites this paper as [21]
The Results > Treatment section reports outcomes of this paper’s retrospective ocular-pain study, and the Discussion notes its lack of a control group. Neither section addresses how many systematic reviews or randomized controlled trials evaluate physical therapy interventions; searches for those terms found no passage that does. (LLM, conf=0.76)
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Lam, A. C., Liddle, L. J., & MacLellan, C. L. (2023) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2022.100242 · Cited by 14 · see citing works
“Few systematic reviews evaluate the efficacy of physical therapy interventions, and a limited number of randomized controlled trials (RCTs) evaluate any particular physical therapy intervention.(13,21,22) These reviews suggest that MT combined with other interventions improves outcomes for those with TMJ dysfunction.”
Background
- Authors
- Tseng, S. C., Cheng, A. M., & Fu, Y.
- Affiliations
- Ocular Surface Center (US)
- Florida International University (US)
- Shanghai Jiao Tong University (CN)
- Corresponding author
- Tseng, Scheffer CG
- Venue
- Journal of Pain Research
- Publisher
- Informa UK Limited
- Published
- 2017-07
- Volume
- Volume 10
- Pages
- 1747-1754
- ISSN
- 1178-7090 (ISSN-L)
- PMC
- PMC5536137
- OpenAlex
- W2737638202
- Cited by
- 5
- References
- 0
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 1 · 2019: 1 · 2018: 1
- FWCI
- 0.29
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Pain Research (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Shanghai Leading Academic Discipline Project (S30205)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Myofascial pain diagnosis and treatment
- Health Sciences › Health Professions › Complementary and Manual Therapy › Temporomandibular Joint Disorders
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ocular Surface and Contact Lens
- Keywords
- ocular pain, trigger points, occipital neuralgia, trigger point injection, headache, referred pain, prevalence
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