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Failure to Make the Correct Diagnosis – Part II (A Physical Therapist’s Perspective)

  • Steve KrausEmail author
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Abstract

The 2013 International Headache Society (IHS) has identified 14 diagnostic categories for headache and facial pain [1] (Appendix 1). Each of these categories have several diagnostic subtypes for a total of 284 sources for headache and facial pain. This extensive list of headache and facial pain disorders becomes a diagnostic challenge even for the most seasoned clinicians. A thorough history and a cranial nerve exam assessing neurological deficit(s) and/or altered mental state can eliminate more serious pathologies that may be causing headache and facial pain. If pathology or infection is suspected, imaging studies and blood analysis would rule out most concerns [2]. Neuropathic and neurogenic sources for headache and facial pain must be considered but are very complex and difficult to diagnose [3]. Category 11 of the IHS classification system addresses additional diagnoses that are relatively common and can mimic and compound temporomandibular joint pain (Boxes 2.1 and 2.2).

Keywords

Neck Pain Facial Pain International Headache Society Disc Displacement Diagnostic Protocol 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

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References

  1. 1.
    Headache Classification Committee of the International Headache Society (IHS). The international classification of headache disorders, 3rd ed. Cephalalgia. 2013;33(9):629–808.Google Scholar
  2. 2.
    Chou R, Qaseem A, Owens DK, et al. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Ann Intern Med. 2011;154(3):181–9.CrossRefPubMedGoogle Scholar
  3. 3.
    Marbach JJ. Is phantom tooth pain a deafferentation (neuropathic) syndrome? Part II: Psychosocial considerations. Oral Surg Oral Med Oral Pathol. 1993;75(2):225–32.CrossRefPubMedGoogle Scholar
  4. 4.
    Costen JB. A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint. Ann Otol Rhinol Laryngol. 1934;43:1–15.CrossRefGoogle Scholar
  5. 5.
    Profitt WR, Epker BN, Ackerman JL. Systematic description of dentofacial deformities: the database. In: Bell WH, Profitt WR, White RP, editors. Surgical correction of dentofacial deformities, vol. 1. Philadelphia: WB Saunders; 1980. p. 105–54.Google Scholar
  6. 6.
    Gremillion HA. TMD and maladaptive occlusion: does a link exist? J Craniomandib Pract. 1995;13(4):205–6.Google Scholar
  7. 7.
    Cooper BC, International College of Cranio-Mandibular Orthopedics (ICCMO). Temporomandibular disorders: a position paper of the International College of Cranio-Mandibular Orthopedics (ICCMO). Cranio. 2011 Jul;29(3):237–44.CrossRefPubMedGoogle Scholar
  8. 8.
    Koh H, Robinson PG. Occlusal adjustment for treating and preventing temporomandibular joint disorders. The Cochrane Library. 2005;(2).Google Scholar
  9. 9.
    Gremillion H. The relationship between occlusion and TMD: an evidence-based discussion. J Evid Base Dent Pract. 2006;6:43–7.CrossRefGoogle Scholar
  10. 10.
    Klasser GD, Greene CS. The changing field of temporomandibular disorders: what dentists need to know. J Can Dent Assoc. February 2009;75(1):49–53.PubMedGoogle Scholar
  11. 11.
    Xie Q, Li X, Xu X. The difficult relationship between occlusal interferences and temporomandibular disorder – insights from animal and human experimental studies. J Oral Rehabil. 2013;40:279–92.CrossRefPubMedGoogle Scholar
  12. 12.
    Greene CS. The Etiology of Temporomandibular Disorders: Implication for Treatment. J Orofac Pain. 2001;15:93–105.PubMedGoogle Scholar
  13. 13.
    Mohl ND. Reliability and validity of diagnostic modalities for temporomandibular disorders. Adv Dent Res. August 1993;7:113–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Greene CS. The role of technology in TMD diagnosis. In: Laskin DM, Greene CS, Hylander WL, editors. TMDs – an evidence-based approach to diagnosis and treatment. Chicago: Quintessence Publishing Co; 2006. p. 193–202.Google Scholar
  15. 15.
    Petersson A. What you can and cannot see in TMJ imaging--an overview related to the RDC/TMD diagnostic system. J Oral Rehabil. 2010;37:771–8.CrossRefPubMedGoogle Scholar
  16. 16.
    Aiken A, Bouloux G, Hudgins P. MR imaging of the temporomandibular joint. Magn Reson Imaging Clin N Am. 2012 Aug;20(3):397–412.CrossRefPubMedGoogle Scholar
  17. 17.
    Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord Facial Oral Pain. 1992;6:301–55.Google Scholar
  18. 18.
    Schiffman E, Ohrbach R, Truelove E, Look J, Anderson G, Goulet JP, et al. Diagnostic criteria for temporomandibular disorders (DC/TMD) for clinical and research applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Groupdagger. J Oral Facial Pain Headache. 2014;28:6–27.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Kraus S. Characteristics of 511 TMD patients referred for physical therapy. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118:432–9.CrossRefPubMedGoogle Scholar
  20. 20.
    Lobbezoo-Scholte AM, Lobbezzo F, Steenks MH, et al. Diagnostic subgroups of craniomandibular disorders, part II: symptom profiles. J Orofac Pain. 1995;9:37–43.. Latremoliere I, Woolf CJ. Central Sensitization: A Generator of Pain Hypersensitivity by Central Neural Plasticity. J Pain. 2009;10(9): 895–926.PubMedGoogle Scholar
  21. 21.
    Al-Hasson HK, Ismail AI, Ash Jr MM. Concerns of patients seeking treatment for TMJ dysfunction. J Prosthet Dent. 1986;56:217–21.CrossRefPubMedGoogle Scholar
  22. 22.
    List T, Dworkin SF. Comparing TMD diagnoses and clinical findings at Swedish and US TMD centers using research diagnostic criteria for temporomandibular disorders. J Orofac Pain. 1996;10:240–53.PubMedGoogle Scholar
  23. 23.
    Naeije M, Te Veldhuis AH, Te Veldhuis EC, Visscher CM, Lobbezzo F. Disc displacement within the human temporomandibular joint: a systematic review of a ‘noisy annoyance’. J Oral Rehabil. 2013;40:139–58.CrossRefPubMedGoogle Scholar
  24. 24.
    Stegenga B. Osteoarthritis of the temporomandibular organ and its relationship with disc displacement. J Orofac Pain. 2001;15:193–205.PubMedGoogle Scholar
  25. 25.
    Dommerholt J, Shah J. Myofascial pain syndrome. In: Ballantyne JC, Rathmell JP, Fishman SM, editors. Bonica’s management of pain. Baltimore: Lippincott, Williams & Williams; 2010. p. 450–71.Google Scholar
  26. 26.
    Petersen-Felix S, Curatolo M. Neuroplasticity – an important factor in acute and chronic pain. Swiss Med Wkly. 2002;132:273–8.PubMedGoogle Scholar
  27. 27.
    Gatchel RJ, Bo Peng Y, Peters ML, Fuchs PN. The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin Am Psychol Assoc. 2007;Vol. 133(4):581–624.CrossRefGoogle Scholar
  28. 28.
    Bonathan CJ, Zakrzewska JM, Love J, Williams AC. Beliefs and distress about orofacial pain: patient journey through a specialist pain consultation. J Oral Facial Pain Headache. 2014;28:223–32.CrossRefPubMedGoogle Scholar
  29. 29.
  30. 30.
    Fejer R, Kyvik K, Hartvigsen J. The prevalence of neck pain in the world population: a systemic critical review of the literature. Eur Spine J. 2006;15(6):834–48.CrossRefPubMedGoogle Scholar
  31. 31.
    Ciancaglini R, Testa M, Radaelli G. Association of neck pain with symptoms of TMD in the general adult population. Scand J Rehabil Med. 1999;31:17–22.CrossRefPubMedGoogle Scholar
  32. 32.
    Sjaastad O, Fredriksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache. 1998;38:442–5.CrossRefPubMedGoogle Scholar
  33. 33.
    Biondi DM. Cervicogenic headache: mechanisms, evaluation, and treatment strategies. JAOA. 2000;100(9 Suppl):S7–S14.PubMedGoogle Scholar
  34. 34.
    Calhoun AH, Ford S, Millen C, et al. The prevalence of neck pain in migraine. Headache. 2010;50:1273–7.CrossRefPubMedGoogle Scholar
  35. 35.
    Shevel E, Spierings E. Cervical muscles in the pathogenesis of migraine headache. J Headache Pain. 2004;5(1):12–4.CrossRefPubMedCentralGoogle Scholar
  36. 36.
    Nilsson N. The prevalence of cervicogenic headache in a random population sample of 20-59 year olds. Spine. 1995;20(17):1884–8.CrossRefPubMedGoogle Scholar
  37. 37.
    Piovesan EJ, Kowacs PA, Oshinsky MI. Convergence of cervical and trigeminal sensory afferents. Curr Pain Headache Rep. 2003;7:377–83.CrossRefPubMedGoogle Scholar
  38. 38.
    Bogduk N. The neck and headaches. Neurol Clin. 2004 Feb;22(1):151–71.CrossRefPubMedGoogle Scholar
  39. 39.
    Manchikanti L, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Phys. 2003;6:3–81.Google Scholar
  40. 40.
    The Bone and joint fecade (2000–2010) task force on neck pain and its associated disorders. Spine. 2008;33:S4.Google Scholar
  41. 41.
    Jull G, Bogduk N, Marsland A. The accuracy of manual diagnosis for cervical zygapophysial joint pain syndromes. Med J Aust. 1988;148(5):233–6.PubMedGoogle Scholar
  42. 42.
    Viikari-Juntura E, et al. Validity of clinical tests in the diagnosis of root compression in cervical disc disease. Spine. 1989;14:253–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Tong, C. The Spurling’s test and cervical radiculopathy. Spine. 2002;27(2):156–9Google Scholar
  44. 44.
    van Duijn J, van Duijn AJ, Nitsch W. Orthopedic manual physical therapy including thrust manipulation and exercise in the management of a patient with cervicogenic headache: a case report. J Man Manip Ther. 2007;15(1):10–24.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Mense S, Simons DG, Russell J. Muscle pain: understanding its nature, diagnosis, and treatment. N Engl J Med. 2001;344:1026–1027. March 29, 2001.Google Scholar
  46. 46.
    Fernández-de-Las-Peñas C, Galan-del-Rio F, Alonso-Blanco C, et al. Referred pain from muscle trigger points in the masticatory and neck-shoulder musculature in women with temporomandibular disorder. J Pain. 2010;11(12):1295–304.CrossRefPubMedGoogle Scholar
  47. 47.
    Rocha CB, Sanchez TG. Efficacy of myofascial trigger point deactivation for tinnitus control. Braz J Otorhinolaryngol. 2012;78(6):21–6.CrossRefPubMedGoogle Scholar
  48. 48.
    William S. Teachey. Otolaryngic myofascial pain syndromes. Curr Pain Headache Rep. 2004;8:457–62.CrossRefGoogle Scholar
  49. 49.
    Calandre EP, Hidalgo J, Garcia-Leiva JM, Rico-Villademoros F. Trigger point evaluation in migraine patients: an indication of peripheral sensitization linked to migraine predisposition? Eur. J Neurol. 2006;13(3):244–9.Google Scholar
  50. 50.
    Hsieh YL, Kao MJ, Kuan TS, Chen SM, Chen JT, Hong CZ. Dry needling to a key myofascial trigger point may reduce the irritability of satellite MTrPs. Am J Phys Med Rehabil. 2007;86(5):397–403.CrossRefPubMedGoogle Scholar
  51. 51.
    Fernández-de-Las-Peñas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility and forward head posture in unilateral migraine. Cephalalgia. 2006;26:1061–70.CrossRefPubMedGoogle Scholar
  52. 52.
    Fernández-de-Las-Peñas C, Alonso-Blanco C, Cuadrado ML, Pareja JA. Forward head posture and neck mobility in chronic tension-type headache: a blinded, controlled study. Cephalalgia. 2005;26:314–9.CrossRefGoogle Scholar
  53. 53.
    Fernández-de-Las-Peñas C, Cuadrado ML, Pareja JA. Myofascial trigger points, neck mobility, and forward head posture in episodic tension-type headache. Headache. 2007;47:662–72.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Division of Physical Therapy, Department of Rehabilitation MedicineEmory University School of MedicineAtlantaUSA
  2. 2.The Georgia School of OrthodonticsAtlantaUSA

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