Thoracic spine manipulation did not improve maximal mouth opening in participants with temporomandibular dysfunction

Abstract

Background and Purpose Temporomandibular joint disorders (TMD) have a prevalence of more than 5% in the general population. A positive correlation exists between temporomandibular joint mobility and cervical spine mobility. Similarly, a relationship exists between thoracic and cervical spine mobility. However, it is unknown if interventions to improve the mobility of the thoracic spine positively impact temporomandibular joint motion and pain. This study tested the hypothesis that a single thoracic thrust joint manipulation (TJM) would improve maximum mouth opening (MMO) compared with participants without TMD as well as decrease TMD symptoms. Methods Forty‐eight people with TMD (30.9 years old ±11.3) and 55 people without TMD (28.5 years old ±9.2) participated. Both groups received a seated upper thoracic TJM and were measured for MMO before and immediately following the TJM. The duration of TMD symptoms and pre‐thrust current pain, using the 11‐point Verbal Pain Rating Scale (VPRS), was recorded in the TMD group. Participants in the TMD group were contacted 2–3 days after TJM to report current VPRS and improvement utilizing the Global Rating of Change (GROC) scale. Results No difference in MMO treatment response over time was observed between groups (p = .56). The MMO in the TMD group improved from 40 to 41.3 mm, and the non‐TMD similarly improved from 44.5 to 45.4 mm. The VPRS decreased from 2.4 (±1.8) to 1.3 (±1.5) following thoracic TJM (p < .001), and the average GROC score was 1.8 (±2.25), which was statistically different than zero (no change; p < .001). The duration of TMD symptoms prior to TJM was not associated with GROC scores (r = .018, p = .90) or VPRS change scores (r = −.07, p = .64). Conclusion The observed treatment effects did not exceed previously reported standards for clinical relevance (5 mm and 2 points, respectively).

Are jaw range of motion, muscle function and proprioception impaired in adults with persistent temporomandibular disorders? A systematic review and meta‐analysis

“…Joint position sense was reported in five studies. Two studies reported increased joint position error in TMD groups compared with controls, while two studies found no significant difference 56 Mod Lafreniere et al 1997 57 Mod MazzeƩo et al 2017 34 Mod Miller et al 1999 81 Mod Miller et al 2000 58 Mod Monteiro et al 1987 59 Mod PiƩa et al 2015 37 Mod Pizolato et al 2007 38 Mod Rauch et al 2018 39 Mod Rezaie et al 2017 40 Mod Seligman et al 1988 61 Mod Stegenga et al 1990 62 Mod Thorp et al 2019 67 Mod Todic et al 2019 70 Mod Tsolka et al 1994 71 Mod Turp et al 2005 43 Mod Visser et al 1995 63 Mod Wang et al 2018 72 Mod Xu et al 2017 44 Mod Zhang et al 2017 64 Mod Badel et al 2011 19 High Dahlstrom et al 1989 50 High Dworkin et al 1990 52 High Goulet et al 1998 77 High Isacsson et al 1988 54 High Lindauer et al 1986 80 High Nielsen et al 1990 60 High Nielsen et al 1987 78 High Van Willigen et al 1986 82 High 61 Reduced in all TMD groups compared to assymptomatic controls (P < .001 all except DDwR where P < .05). Reduced in all TMD groups, except DDwR, compared to symptomatic controls (P < .001)…”

Temporomandibular Disorder Treated With Chiropractic Therapy

“…Another randomized controlled trial that investigated the effects of adding cervical spinal manipulation to standard care for TMD also found that cervical spinal manipulation had better outcomes in improving TMD-associated pain, mouth opening, disability, fear avoidance, and global perceived effect [ 14 ]. However, a previous study found that thoracic spinal manipulation does not affect TMD [ 15 ]. As the previous case report found relief of atypical symptoms with correction of cervical and thoracic curvature [ 16 ], the chiropractor decided to provide the treatment to both cervical and thoracic correction to reach the maximum outcome.…”