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Is there a relationship between head posture and craniomandibular pain?

September 7, 2013

SUMMARY: An often-suggested factor in the aetiology of craniomandibular disorders (CMD) is an anteroposition of the head. However, the results of clinical studies to the relationship between CMD and head posture are ontradictory. Therefore, the first aim of this study was to determine differences in head posture between well-defined CMD pain patients with or without a painful cervical spine disorder and healthy controls. The second aim was to determine differences in head posture between myogenous and arthrogenous CMD pain patients and controls. Two hundred and fifty persons entered the study. From each person, a standardized oral history was taken and blind physical examinations of the masticatory system and of the neck were performed. The participants were only included
into one of the subgroups when the presence or absence of their symptoms was confirmed by the results of the physical examination. Head posture was quantified using lateral photographs and a lateral radiograph of the head and the cervical spine. After correction for age and gender effects, no difference in head posture was found between
any of the patient and non-patient groups (P >0Æ27). Therefore, this study does not support the suggestion that painful craniomandibular disorders, with or without a painful cervical spine disorder, are related to head posture.
KEYWORDS: craniomandibular disorders, cervical spine disorders, head posture, neck pain, temporomandibular disorders.

Results
No difference in head posture measured on the photographs with the participant in a sitting or a standing position was found (t ¼ 1Æ64, P ¼ 0Æ10). Therefore, the meanvalues of thetwophotographswereused in further analysis. A significant positive correlation was found between the head posture measured on the radiograph and on the photographs (R ¼ 0Æ43, P ¼ 0Æ00). In Table 2 the mean values and standard deviations of the two angles used to quantify head posture are shown for the non-patient group, the group with a painful CMD, the group with a painful CSD and the group with a painful CMD and CSD. For both methods, no difference was found in head posture between the groups (see Table 3). For the photographs, increasing age was associated with a more anteroposition of the
head (t ¼ )2Æ39, P ¼ 0Æ02). No significant interactions between age and head posture were present. Table 4 shows the mean values and the standard deviations of the head posture for the non-CMD group, the group with a myogenous CMD, the group with an arthrogenous CMD and the group with a myogenous and an arthrogenous CMD. No  ifference in head posture was found between the subgroups of CMD patients and the non-CMD patients and a positive age
effect was present for the photographs (Table 5). No interactions were present.

Visscher CM, De Boer W, Lobbezoo F, Habets L, Naeije M. Is there a relationship between head posture and craniomandibular pain? Journal of Oral Rehabilitation. 2002 Nov;29(11):1030-6. PubMed PMID: WOS:000179548100002.


The Relationship between Posture and Curvature of the Cervical Spine THE NECK DISABILITY INDEX:STATE-OF-THE-ART, 1991-2008
The Relationship between Posture and Curvature of the Cervical Spine
THE NECK DISABILITY INDEX:STATE-OF-THE-ART, 1991-2008
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