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Old 05-11-2011, 12:43 PM
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fmichael fmichael is offline
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fmichael fmichael is offline
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Join Date: Sep 2006
Location: California
Posts: 1,239
15 yr Member
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Dear Nigel -

Sorry for getting in late here, but searching PubMed http://www.ncbi.nlm.nih.gov/sites/entrez?db=PubMed for "CRPS Hanover," I found a practice group in the Department of Rehabilitation Medicine, Hanover Medical School, Hanover, Germany, that's published two articles in the last three years that seem to be largely on point for your concerns. There is a charge for downloading the articles. but the abstracts with one of the authors contact information are freely available:
Influence of the temporomandibular joint on range of motion of the hip joint in patients with complex regional pain syndrome, Fischer MJ, Riedlinger K, Gutenbrunner C, Bernateck M, J Manipulative Physiol Ther. 2009 Jun;32(5):364-71.
Department of Rehabilitation Medicine, Hanover Medical School, Hanover, Germany. fischer.michael@mh-hannover.de

Abstract
OBJECTIVE: This study evaluated if patients with complex regional pain syndrome (CRPS) would have an increase in range of motion (ROM) after myofascial release and a similar ROM decrease after jaw clenching, whereas in healthy subjects these effects would be minimal or nonexistent.

METHODS: Documentation of patients with CRPS (n = 20) was established using the research diagnostic criteria for CRPS, questionnaires, average pain intensity for the past 4 weeks, and the temporomandibular index (TMI). Healthy subjects (n = 20, controls) also underwent the same testing. Hip ROM (alpha angle) was measured at 3 time points as follows: baseline (t1), after myofascial release of the temporomandibular joint (t2), and after jaw clenching for 90 seconds (t3). Comparison of the CRPS and control groups was made using t tests.

RESULTS: Mean TMI total score and mean pain reported for the last 4 weeks were significantly different between the 2 groups (P < .0005). Hip ROM at t1 was always slightly higher compared to t3, but t2 was always lower in value compared to t1 or t3 for both groups. The differences of all hip ROM values between the groups were significant (P < .0005). Moreover, the difference between t1 or t3 and t2 was significantly different within the CRPS group (t1 = 48.7 degrees ; t2 = 35.8 degrees ; P < .0005).

CONCLUSIONS: The results suggest that temporomandibular joint dysfunction plays an important role in the restriction of hip motion experienced by patients with CRPS, which indicated a connectedness between these 2 regions of the body.

PMID: 19539119 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/19539119
AND
Do occlusal splints have an effect on complex regional pain syndrome? A randomized, controlled proof-of-concept trial, Fischer MJ, Reiners A, Kohnen R, Bernateck M, Gutenbrunner C, Fink M, Svensson P, Clin J Pain 2008 Nov-Dec;24(9):776-83.
Department of Physical and Rehabilitation Medicine, Pain Clinic, Hanover Medical School, Hanover, Germany. fischer.michael@mh-hannover.de

Abstract
OBJECTIVES: Studies have suggested overlaps between various chronic pain conditions and painful temporomandibular disorders (TMDs). The objective of this pilot study was to assess the effectiveness of occlusal splint (OS) therapy on self-reported measures of pain in patients with chronic complex regional pain syndrome (CRPS) as compared with a nontreatment group.

METHODS: The design was a prospective randomized controlled clinical trial. Twenty patients with CRPS were randomly assigned to either the OS or control group. The patients in the OS group were asked to use the OS at nighttime and for 3 hours during daytime for a total of 7 weeks; the control group had no stomatognathic intervention. The primary outcome was self-reported assessment of CRPS-related pain on numerical rating scales. Secondary outcome measures were the Temporomandibular Index (TMI), and the Short Form 36 Health Survey (SF-36).

RESULTS: All patients had TMD signs and symptoms, but OS had no effect on CRPS-related pain on the numerical rating scale (P>0.100). The changes in the TMI scores over time were 16.6%+/-24.6% (improvement) in the OS group and -21.3%+/-25.9% (impairment) in the control group that was significant (P=0.004). There were no differences in the changes of SF-36 scores between groups (P=0.636).

DISCUSSION: The use of OS for 7 weeks has no impact on CRPS-related pain but improved signs and symptoms of TMD pain. Future studies should include an active control group and evaluate if long-term changes in measures of oral health impact general health in CRPS-related pain.

PMID: 18936595 [PubMed - indexed for MEDLINE]
http://www.ncbi.nlm.nih.gov/pubmed/18936595
Note: in reading the the names of the authors, the principal researcher is general listed first, while the name of the most senior participating scientist (if s/he is not the principal researcher) appears as the last name in the right.

I hope this is helpful. I suspect you can easily find their departmental homepage on the Net.

Mike
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"Thanks for this!" says:
ballerina (05-11-2011)