Ulman-Macón Daniel, Fernández-de-Las-Peñas César, Angulo-Díaz-Parreño Santiago, Arias-Buría José L, Mesa-Jiménez Juan A
Department of Physical Therapy, Universidad San-Pablo CEU, 28660 Madrid, Spain.
Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain.
Life (Basel). 2023 May 11;13(5):1159. doi: 10.3390/life13051159.
Temporomandibular disorder (TMD) is an umbrella term including pain problems involving the cranio-cervical region. It has been suggested that patients with TMD also exhibit cervical spine disturbances. Evidence suggests the presence of morphological changes in the deep cervical muscles in individuals with headaches. The objective of this study was to compare the morphology of the suboccipital muscles between women with TMD and healthy controls. An observational, cross-sectional case-control study was conducted. An ultrasound examination of the suboccipital musculature (rectus capitis posterior minor, rectus capitis posterior major, oblique capitis superior, oblique capitis inferior) was conducted in 20 women with myofascial TMD and 20 matched controls. The cross-sectional area (CSA), perimeter, depth, width, and length of each muscle were calculated by a blinded assessor. The results revealed that women with myofascial TMD pain exhibited bilaterally reduced thickness, CSA, and perimeter in all the suboccipital muscles when compared with healthy women. The width and depth of the suboccipital musculature were similar between women with myofascial TMD and pain-free controls. This study found morphological changes in the suboccipital muscles in women with myofascial TMD pain. These changes can be related to muscle atrophy and are similar to those previously found in women with headaches. Future studies are required to investigate the clinical relevance of these findings by determining if the specific treatment of these muscles could help clinically patients with myofascial TMD.
颞下颌关节紊乱病（TMD）是一个涵盖涉及颅颈区域疼痛问题的统称。有人提出，TMD患者也存在颈椎功能紊乱。有证据表明，头痛患者的颈深部肌肉存在形态学改变。本研究的目的是比较TMD女性患者与健康对照者枕下肌肉的形态。进行了一项观察性横断面病例对照研究。对20名肌筋膜性TMD女性患者和20名匹配的对照者进行了枕下肌肉组织（头后小直肌、头后大直肌、头上斜肌、头下斜肌）的超声检查。由一名不知情的评估者计算每块肌肉的横截面积（CSA）、周长、深度、宽度和长度。结果显示，与健康女性相比，患有肌筋膜性TMD疼痛的女性双侧枕下肌肉的厚度、CSA和周长均减小。肌筋膜性TMD女性患者与无疼痛对照者的枕下肌肉组织宽度和深度相似。本研究发现患有肌筋膜性TMD疼痛的女性枕下肌肉存在形态学改变。这些改变可能与肌肉萎缩有关，并且与先前在头痛女性中发现的改变相似。未来需要通过确定对这些肌肉的特异性治疗是否有助于肌筋膜性TMD临床患者来研究这些发现的临床相关性。
