Rubis Lisa M, Rubis David, Winchester Brett
Chiropractor, ANEW Medical and Rehabilitation, Joliet, IL.
Dentist, Advanced Family Dental, Crest Hill, IL.
J Chiropr Med. 2014 Mar;13(1):55-61. doi: 10.1016/j.jcm.2013.10.003.
The purpose of this case report is to describe the chiropractic and dental comanagement of a patient with temporomandibular dysfunction, headaches, and myalgia.
A 38-year-old black female patient presented for chiropractic care with a chief concern of jaw pain, tinnitus, headaches, and neck and shoulder soreness of 8 months' duration. The patient rated the pain a 6/10. The patient had a maximum mouth opening of 42 mm, graphed evidence of disk displacement, loss of translation on opening of the right temporomandibular joint viewed on the lateral radiograph, and numerous areas of point tenderness on the Kinnie-Funt Chief Complaint Visual Index. She had decreased lateral cervical flexion.
Dental treatment consisted of an anterior repositioning splint. Chiropractic care consisted of Activator treatment to the pelvis and the thoracic and cervical spine. Manual manipulation of the temporomandibular joint was performed along with a soft tissue technique intraorally on the lateral pterygoid. Postisometric relaxation in the head and neck region was also done. The patient was treated 6 times over 3 weeks. At the end of treatment, the patient had a pain rating of 0/10, maximum mouth opening of 49 mm, no tender points on the follow-up Kinnie-Funt, and increased cervical range of motion.
The patient demonstrated increased mouth opening, decreased pain rating, improved Kinnie-Funt visual index, and an increased cervical lateral flexion range of motion after 3 weeks of a combination of chiropractic and dental care.
本病例报告旨在描述一名患有颞下颌关节功能障碍、头痛和肌痛患者的脊椎按摩疗法与牙科联合治疗情况。
一名38岁的黑人女性患者前来接受脊椎按摩治疗,主要诉求为持续8个月的颌部疼痛、耳鸣、头痛以及颈部和肩部酸痛。患者将疼痛程度评为6/10。患者最大开口度为42毫米,有盘状移位的影像学证据,侧位X线片显示右侧颞下颌关节开口时平移丧失,在金尼 - 芬特主要症状视觉指数上有多处压痛区域。她的颈椎侧屈活动度降低。
牙科治疗包括佩戴前伸复位夹板。脊椎按摩治疗包括对骨盆以及胸椎和颈椎进行激活器治疗。对颞下颌关节进行手法操作,并在口内对翼外肌进行软组织治疗技术。还对头颈部区域进行等长收缩后放松。患者在3周内接受了6次治疗。治疗结束时,患者疼痛评分为0/10,最大开口度为49毫米,随访的金尼 - 芬特检查中无压痛点,颈椎活动度增加。
经过3周的脊椎按摩疗法与牙科联合治疗后,患者的开口度增加、疼痛评分降低、金尼 - 芬特视觉指数改善,颈椎侧屈活动度增加。