What do Ear Pain and TMJ have to do with neck weakness?

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The following study describes the relationship between weakness in the deep neck flexors and the otalgia (ear pain) that can often accompany temporomandibular disorders (TMD). A total of 57 participants were divided into those with a diagnosed TMD with “otological complaints” (31) or without (26). Those presenting with concurrent ear pain also demonstrated significant dysfunction with the deep neck flexors, indicating the need to rehabilitate these as part of a comprehensive rehab strategy.

Pain, deep neck flexors performance, disability, and head posture in individuals with temporomandibular disorder with and without otological complaints.

Tavares LF, Gadotti IC, Ferreira LM, Maciel ACC, Carvalho BG, Barbosa GS, Almeida EO, Ribeiro KF.J Back Musculoskelet Rehabil. 2023;36(2):465-475.

Background: Otological complaints (OC) are highly prevalent in subjects with temporomandibular disorders (TMD) and so is the risk of neck dysfunctions.

Objective: To evaluate pain, deep neck flexor (DNF) performance, disability, and head and neck posture of individuals with TMD with and without OC.

Methods: In this cross-sectional study, 57 individuals were divided into a group with TMD and OC (n= 31) and a group with TMD without OC (n= 26). Self-reported pain intensity, masticatory and neck muscles pressure pain thresholds, DNF performance, neck disability, and head and neck posture were evaluated. Data were compared between groups using the independent t test and Mann-Whitney test with Bonferroni correction for multiple comparisons. Effect sizes were evaluated using Cohen’s index.

Results: The TMD with OC group presented less muscle activation [26 (24-28) vs. 24 (24-26) mmHg; p< 0.05], less endurance [105 (46-140) vs. 44 (28-78) points; p< 0.05], and greater neck disability (8.15 ± 5.89 vs. 13.32 ± 6.36 points; p< 0.05). No significant difference was observed in self-reported pain, head and neck posture, or pressure pain thresholds.

Conclusion: Individuals with TMD with OC presented decreased DNF performance and increased neck disability compared to individuals with TMD without OC.