• Title/Summary/Keyword: Myofascial Pain Syndrome

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THE EPIDEMIOLOGIC STUDY OF THE PATIENTS WITH TEMPOROMANDIBULAR JOINT DISORDERS, USING RESEARCH DIAGNOSTIC CRITERIA FOR TMD (RDC/TMD): PRELIMINARY REPORT (턱관절장애의 연구진단기준을 이용한 역학적 연구;예비보고)

  • Im, Jae-Hyung;Kim, Young-Kyun;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.2
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    • pp.187-195
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    • 2008
  • Purpose: This epidemiologic research was carried out to investigate the degree and aspects of symptoms of patients suffered from TMD using RDC/TMD. Subjects and Methods: Subjects were the patients who had visited to SNUBH dental clinic from Jan. 2005 to Dec. 2005, and total 117 patients were included (M: 22, F:95). The signs and symptoms of physical, psychological and behavioral factors were retrospectively evaluated by questionnaires in the RDC/TMD. The patients were examined through clinical and radiological method, and diagnosed by same investigator. They were divided into 3 groups such as osteoarthritis group (group 1), internal deragnement (group 2), myofascial pain dysfunction syndrome group (MPDS, group 3). In addition, in patient with complex diagnosis they were divided into subgroups in detail (ex. group 1+group 2). In the questionnaire, several items were selected to calculate the graded pain score (grade $0{\sim}IV$), depression and vegetative symptoms, nonspecific physical symptoms(pain items included) and nonspecific physical symptoms(pain items excluded) in each group. Results: As a result of classification by diagnostic criteria of this study, the patients were distributed to 45% of group 1, 47% of group 2, 8% of group 3 in this study. In younger patients (under 25-year old, n=40), group 2 was occupied 57% (n=23) and group 1 was 35%, group 3 was 8%, while group 1 was occupied 75% in elderly-patients (over 40-year old, n=28) in present study (group 2: 21%, group 3: 4%). In the analysis of depression and vegetative symptoms, majority of patients in Group 2 were included in 'normal', and in Group 3 it appeared to have larger proportion of 'moderate' & 'severe' than others. According to nonspecific physical symptoms, there have been tendencies of higher ratio of 'severe' in patients with MPDS. In graded pain score, more than half (58%) of subjects were included in grade 0 and low disability (Grade I and II), and 27% were revealed high disability (grade III, IV).

Clinical Assessment of Temporomandibular Joint Dysfunction (측두하악 관절 장애의 평가)

  • Ryoo, Jae-Kwan;Kim, Jong-Soon
    • Journal of Korean Physical Therapy Science
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    • v.5 no.4
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    • pp.717-728
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    • 1998
  • The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

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Study of Disclusion Time during Mandibular Eccentric Movement in Myofascial Pain Syndrome Patients by T-Scan II, Computerized Occlusal Analysis System (컴퓨터 교학분석기인 T-Scan II를 이용한 측방운동시 구치부 이개시간에 관한 연구)

  • Shin, Jun-Han;Kwon, Jeong-Seung;Kim, Seong-Taek;Park, Hyung-Uk;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.36 no.3
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    • pp.187-197
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    • 2011
  • Temporomandibular disorders(TMD) is a collective term which is embracing a number of clinical problems that involve the masticatory musculature, the TMJ and associated structures, or both. Myofascial pain, which is a kind of masticatory muscle disorder of TMD, is the sensory, motor, and autonomic symptoms caused by myofascial trigger points. There has been some controversies regarding etiologies of TMD and MFP. Especially the issue of occlusal conditions has been a critical issue for long time. Despite much efforts, the results of studies regarding occlusal conditions were contradictory. These controversies might be mostly due to various factors resulting from the complex nature of TMD, however, inaccurate and inappropriate study design, selection criteria, methodologies also play significant roles. Recently, a computerized occlusal analysis system, T-Scan II which made it possible to reveal quantifiable time data and relative force data for analyzing occlusion, was introduced. Some authorities suggested that the concept of disclusion time and prolonged disclusion time of posterior tooth and MFP are related using T-Scan II. But the previous studies which used T-SCAN II are not reliable for they did not provide accurate diagnostic criteria of MFP. Morever they did not compare with controls, and had many other problems. The purpose of this study was to evaluate the relationship between MFP and prolonged disclusion time of posterior tooth, which is one of the occlusal factors of TMD, by selecting 30 subjects as the study group through strict criteria and comparing them with 38 controls using T-SCAN II, computerized occlusal analysis system. The results, statistically analyzed, are summarized as follows: 1. Cronbach ${\alpha}$ coefficient of repeated measurements of disclusion time was 0.92. 2. There were no statistically significant differences at repeated measured disclusion time of both side between control and study group. 3. There was no statistically significant diffefence in the disclusion time between right and left side. From the results above, we can suggest that there was no relationship between MFP and disclusion time, so irreversible treatments leading to the reduction of disclusion time for treating MFP would not be appropriate. However more controlled, large scaled study, which consider various occlusal factors, and quantification of symptoms using Helkimo index would be necessary in the future.

Vitamin D and fibromyalgia: a meta-analysis

  • Makrani, Atekeh Hadinezhad;Afshari, Mahdi;Ghajar, Marayam;Forooghi, Zahra;Moosazadeh, Mahmood
    • The Korean Journal of Pain
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    • v.30 no.4
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    • pp.250-257
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    • 2017
  • Vitamin D is a cofactor responsible for autoimmune disorders. There is no agreement in the studies investigating the association between vitamin D and fibromyalgia. This study aims to combine the conflicting results of the primary studies which compared these patients with control groups regarding the serum concentration of vitamin D. This meta-analysis has been designed based on PRISMA guidelines. Relevant keywords were searched in PubMed, Science direct, Scopus, Cochrane, and Google scholar and primary studies were selected. After screening the eligible studies according to inclusion/exclusion criteria, we investigated the risk of bias in the selected studies and also the heterogeneity between the primary results using Cochrane (Q) and I-squared ($I^2$) indices. The primary results were combined using inverse variance method and Cohen statistics as well as a random effects model. Publication bias was assessed using Egger test. Sensitivity analysis was applied to investigate the influence of each primary study on the final result of the meta-analysis. Suspected factors in the heterogeneity were assessed using meta-regression models. We entered 12 eligible studies in the meta-analysis including 851 cases compared with 862 controls. The standardized mean difference of Vitamin D between the two groups was -0.56 (95% confidence interval: -1.05, -0.08). Our meta-analysis showed that vitamin D serum levels of patients with fibromyalgia was significantly lower than that of control group.

Feasibility of Extracorporeal Shock Wave Therapy for Complex Upper Limb Morbidity in Breast Cancer Patient (유방암 환자의 복합 상지병증에서 체외충격파치료의 유용성)

  • Ha, Min Cheol;Shin, Ji Cheol;Jung, Yu Sang;Im, Sang Hee
    • Clinical Pain
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    • v.20 no.1
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    • pp.25-29
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    • 2021
  • Upper limb morbidity including shoulder pain, lymphedema, adhesive capsulitis, myofascial pain syndrome, and limited range of motions (LROMs) occurs frequently in breast cancer patients. Especially restricted upper limb motion aggravated by chronic lymphedema results in functional limitation and impaired activities of daily living (ADL). However, conventional rehabilitation therapy including complex decongestive therapy and stretching exercise is insufficient for managing advanced breast cancer patients with complex upper limb morbidity. Here, we report a case of breast cancer-related chronic lymphedema in a 62-years old female with severe LROM in all joints of the affected upper extremity that caused severe disability in ADL. Significant improvements in range of motion and upper extremity function were observed after serial extracorporeal shock wave therapy (ESWT), combined with conventional rehabilitation therapy. Therefore, ESWT might be recommended for managing the extensive limited joint motion which causes functional decline in a patient of chronic lymphedema with trophic skin change.

ESSENTIAL TREATMENT BY REMOVING THE ETIOLOGY OF MYOFASCIAL PAIN DYSFUNCTION SYNDROME AND INTERNAL DERANGEMENT : REVIEW OF LITERATURES & REPORT OF CASES (저작근막동통증후군과 악관절 내장증의 원인치료 : 문헌적 고찰및 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Rhee, Byung-In;Choi, Yong-Seok;Kim, Jin-Kwon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.16 no.3
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    • pp.259-272
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    • 1994
  • The authors reviewed the etiology and essential treatment of temporomandibular disorders. The principal etiology was thought to the the myospasm of masticatory musculatures by stress (major cause) and dental irritation. Therefore, we attempted to control the myospasm by stress management, isometric exercise and regular daily physical exercises (walking, Jogging, bycycling, rope skipping, swimming & gymnastic exercise). The result was more favorable (95% success rate) without recurrence in 123 patients, who was referred to our department of dentistry(Oral & Maxillofacial surgery), Wonju Christian Hospital.

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Study on Infrared Thermography (적외석 체열촬영에 관한 고찰)

  • Kim, Ho-Bong
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.1 no.1
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    • pp.9-14
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    • 1995
  • Thermography is a diagnostic procedures that measures infrared energy emitted by the skin. Thermography detects body temperature change which are controlled by the autonomic nervous system. It does show the thermal dysfunction that correlates closely with pain syndromes as well as normalization when the healing process takes place. Experienced clinical interpretation of the thermal pattern is necessary to diagnose and establish causation. Thermography is useful in the diagnosis of painful conditions such as herniated disc diseases, myofascial syndrome, myositis, musculoligamentous injury, reflex sympathetic dystrophy, athretic injuries, vascular diseases, arthritis, inflammation and breast tumors.

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The clinical observation of patient with Headache Treated by Trigger point acupuncture therapy (발통점(發通點)을 이용(利用)한 두통(頭痛) 치험례(治驗例) 보고(報告))

  • Lee Seung-Yeon;Kim Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.12 no.1
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    • pp.133-143
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    • 1998
  • Myofascial pain syndrome is one of the pain syndrome resulted from myofascia which covered muscles and clinically characteristic feature by sensitive trigger point in skeletal muscles and referred pain reactivated by stimulating each trigger point. The origin of headache are local lesion such as head, chest, abdominal organ, systemic lesion with fever or in toxic state. the other factors are consciousness, personality, anxiety, depression, which cause muscle strain in physiological environment. The Oriental Medical therapy for headache has herb medication and acupuncture. especially acupuncture therapy has not only classical systemic acupuncture(體鍼) but also neo-acupuncture(新鍼) such as commonly using auricular acupuncture(耳鍼) and manual acupuncture (手鍼), recently trigger point acupuncture is used. The author analyzed 27 cases of patient with headache treated by trigger point acupuncture therapy in Dong-yu Oriental Medical Hospital from March 1st 1997 to February 28th 1998. The following results were obtained. 1. The sex ratio of the female was 59.26%(16 cases) and male was 40.74%(11 cases), the ratio of high school student was 62.96%(17cases) as first. 2. The headache duration ratio of 2-3 years was 37.04%(10 cases) as first, 1-2 years was 25.93%(7 cases) as second. 3. The portion ratio of whole headache was 33.33%(9 cases) as first, lateral headache was 29.63%(8 cases) as second 4. The combined symptoms ratio of anorexia was 40.74%(11 cases) as first, fatigue was 33.33%(9 cases) as second, neck stiffness and dizziness was each 25.93%(7 cases) as third. 5. The therapeutic duration ratio of below 1 week was 29.63%(8 cases) as first, 2-3 weeks was 22.22%(6 cases) as second, 1-2 weeks and 3-4 weeks was each 18.52%(5 cases) as third. 6. The ratio of family history was 11 cases(40.74%). mother with headache was 6 cases, father was 3 cases, and brothers & sisters was 2 cases. 7. The herb medication ratio of Chungsanggyuntongtang(淸上?痛湯) was 37.04%(10 cases), Kamiondamtang(加味溫膽湯) was 22.22%(6 cases), Hyangsapyunguisan(香砂平胃散) was 18.25%(5 cases) etc. 8. The remedial effect ratio of good was 25.93%(7 cases), fair was 48.15%(13 cases), not improved was 7.41%(2 cases), side effect was 3.70%(1 cases), and unknown was 14.81%(4 cases).

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Common Trigger Points on College-Level Athletes with Various Sports

  • Park, Joo-Hyun;Shin, Hee-Joon;Lee, Sa-Gyeom;Lee, Geon-Cheol;Yoon, Hee-Jong;Hong, Wan-Sung;Goo, Bong-Oh;Lee, Dong-Yeop;Shin, Hyung-Soo;Yoon, Bum-Chul
    • Journal of International Academy of Physical Therapy Research
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    • v.1 no.1
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    • pp.58-64
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    • 2010
  • The purpose of this study was to investigate the distribution of trigger points(TrPs) on athletes with various sporting background. To achieve the purpose, a study was carried out through a survey from 180 athletes involved in 6 selected sports at Yong-In University. Selected sports included Judo, Taekwondo, Kendo, Ssi-reum(Korean traditional wrestling), Boxing, and Golf. An interview type survey and physical examination were conducted with each thirty athletes from each of the selected sports groups. Technical statistic(SPSS 15.0) was used to analyze the distribution of TrPs on these athletes. The most common TrPs observed in muscles of Trapezius, Quadratus Lumborum, Quadriceps in Judo. In Taekwondo, it was on the trapezius and triceps surae. Kendo athletes had TrPs at sites of trapezius, brachioradialis and triceps surae. Ssirem athletes were found to have TrPs on trapezius, deltoid and quadrates lumborum. In boxers, TrPs appearing at trapezius and brachioradialis were observed. Finally, Golf players were seen to have TrPs at trapezius, quadrates lumborum and brachioradialis. Hence, the analysis shows that there are significant differences of the distribution of TrPs according to the different sport items of the athlete.

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Full-mouth rehabilitation of a patient with severe tooth wear using a gothic arch tracer and stabilization splint. (비기능적 습관에 의한 전반적인 마모 환자의 고딕아치 기록장치 및 교합안정장치를 통한 완전 구강 회복 증례)

  • Sungwoo Ju
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.1
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    • pp.23-32
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    • 2023
  • A patient with para-functional habits can cause widespread teeth wear, along with temporomandibular joint disorders and myofascial pain syndrome in the masticatory muscles. Prolonged teeth wear is associated with a decrease in vertical occlusal dimension, leading to issues such as changes in facial morphology, decreased masticatory efficiency, and temporomandibular joint disorders. To achieve a three-dimensional full-mouth rehabilitation in patients with decreased vertical occlusal dimension, accurate diagnosis, analysis, and proactive treatment planning are essential. Prosthetic treatment accompanied by the restoration of physiological vertical occlusal dimension and the re-establishment of a normal occlusal plane is necessary. This case report presents a full-mouth rehabilitation case involving a patient with overall teeth wear, showing decreased vertical occlusal dimension which results in discomfort in the temporomandibular joint and aesthetic dissatisfaction. The report highlights the successful outcome achieved through the use of occlusal stabilization splint for temporomandibular joint stability and Gothic arch tracing devices for the re-establishment of intermaxillary relationships. Also, through adjustments and adaptation assessment using provisional prostheses, favorable outcomes were achieved both functionally and aesthetically.