INFLUENCE OF THE TEMPOROMANDIBULAR JOINT ON RANGE OF MOTION OF THE HIP JOINT IN PATIENTS WITH COMPLEX REGIONAL PAIN SYNDROME

Objective: This study evaluated if patients with complex regional pain syndrome (CRPS) would have an increase in range of motion (ROM) after myofascial release and a similar ROM decrease after jaw clenching, whereas in healthy subjects these effects would be minimal or nonexistent. Methods: Documentation of patients with CRPS (n = 20) was established using the research diagnostic criteria for CRPS, questionnaires, average pain intensity for the past 4 weeks, and the temporomandibular index (TMI). Healthy subjects (n = 20, controls) also underwent the same testing. Hip ROM (alpha angle) was measured at 3 time points as follows: baseline (t1), after myofascial release of the temporomandibular joint (t2), and after jaw clenching for 90 seconds (t3). Comparison of the CRPS and control groups was made using t tests. Results: Mean TMI total score and mean pain reported for the last 4 weeks were significantly different between the 2 groups (P < .0005). Hip ROM at it was always slightly higher compared to t3, but t2 was always lower in value compared to t1 or G for both groups. The differences of all hip ROM values between the groups were significant (P < .0005). Moreover, the difference between it or t3 and t2 was significantly different within the CRPS group (t1 = 48.7 degrees; Q = 35.8 degrees; P < .0005). Conclusions: The results suggest that temporomandibular joint dysfunction plays an important role in the restriction of hip motion experienced by patients with CRPS, which indicated a connectedness between these 2 regions of the body. (J Manipulative Physiol Ther 2009;32:364-371)