Adding Temporomandibular joint treatments to routine physiotherapy for patients with non-specific chronic neck pain: A randomized clinical study

J Bodyw Mov Ther. 2020 Apr;24(2):202-212. doi: 10.1016/j.jbmt.2019.11.004. Epub 2019 Nov 22.


Introduction: Neck Pain can be related to the disorders of other adjacent areas such as the Temporomandibular Joint (TMJ). This study aimed to investigate whether there is value in adding TMJ treatments to routine physiotherapy in patients with non-specific chronic neck pain compared with a control group.

Methods: A randomized, single-blind, clinical study desined including two groups of patients. Group A (20 people) received routine physiotherapy for neck pain and group B (20 people) received TMJ manual therapy plus exercise therapy in addition to routine physiotherapy for neck pain. The Treatment program included six sessions for two days a week over a period of 21 days. Assessments were performed during the first session, in the last session and one month after treatment as a follow-up. Outcome measures included neck range of motion (ROM), neck disability index (NDI) and visual analogue scale (VAS). Before starting the study, the reliability of methods for measuring neck ROM was evaluated.

Results: Participants were 21 women and 19 men. Initially, a pilot study was carried out on the 40 volunteers to assess the reliability of the measurement methods, and the results were acceptable. With both the control group and the intervention group, the indexes showed significant improvement (p < 0.001), although the intervention group showed more improvement (p < 0.001).

Conclusion: This result means adding treatments of TMJ to routine neck physiotherapy can magnify the effect of the intervention, a significant change still in evidence at follow up. Moreover, given the clinically important differences, our results for VAS and NDI were acceptable.

Keywords: Exercise therapy; Manual therapy; Nonspecific chronic neck pain; Physiotherapy; Temporomandibular joint.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Chronic Pain* / therapy
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Neck Pain* / therapy
  • Physical Therapy Modalities
  • Pilot Projects
  • Range of Motion, Articular
  • Reproducibility of Results
  • Single-Blind Method
  • Temporomandibular Joint
  • Treatment Outcome