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Use of the Operant Orofacial Pain Assessment Device OPAD to Measure Changes in Nociceptive Behavior
Published on: June 10, 2013
Orofacial pain of cervical origin: A case report
G Shankar Ganesh1, Mamata Manjari Sahu2, Pramod Tigga2
1Department of Physiotherapy, SVNIRTAR, Composite Regional Centre for Persons with Disabilities, Mohaan Road, Lucknow 226017, India; Department of Physiotherapy, Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, P.O.Bairoi, Cuttack dt., Odisha 754010, India.
Background:
The etiopathogenesis of orofacial pain remains complex and a number of pain referral patterns for this region have been reported in the literature. The purpose of this report is to describe the assessment and successful clinical management of orofacial pain possibly attributable to cervical origin.
Case Description:
A 55-year-old male teacher with a 3-year history of pain in the right lower jaw, radiating to the ear, consulted our institute for assessment and management. The patient was unsuccessfully treated for dental pain and trigeminal neuralgia. The patient's functioning was grossly limited and the patient was unable to sleep because of severe pain. Current and previous medical and physical examinations revealed no infection, malignancies, or sinusitis. Palpation revealed no temporomandibular disorder, tenderness or myofascial trigger points. Examination of the cervical range of motion showed a reduction in rotation to the right side. The patient was treated for upper cervical joint dysfunction involving mobilization of the first three cervical vertebrae and motor control exercises. The patient had an almost complete resolution of symptoms and reported significant improvement in the Patient Specific Functional Scale (PSFS) and the Global Rating of Change (GRC) scale.
Conclusion:
This case study demonstrates the importance of considering, assessing and treating the cervical spine as a possible source of orofacial pain, and the positive role of cervical mobilization on these disorders.
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