title: Interrelationship between temporomandibular joint osteoarthritis (OA) and cervical spine pain: Effects of intra-articular injection with hyaluronic acid.
abstract: OBJECTIVE
  The aim of this study was to evaluate cervical spine pain and function after five sessions of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) osteoarthritis.
  
  
  METHODS
  Forty-nine patients, (79% females, aged between 43-81 years), affected by TMJ osteoarthritis and concurrent cervical spine pain and limited function were recruited. All patients underwent a cycle of five weekly arthrocenteses and viscosupplementation with 1 ml of medium molecular weight HA according to the single-needle arthrocentesis technique. Outcome variables were TMJ pain (VAS), cervical active ranges of motion, cervical disability (NPDS), and presence of painful palpation sites. Assessments were carried out at baseline and at one, three and six months after the end of treatment protocol.
  
  
  RESULTS
  A significant reduction over time was shown both in TMJ pain levels and in NPDS values with respect to baseline (p < 0.001). Most parameters of active cervical range of motion showed an improvement with time. Benefits remained stable throughout six months after the viscosupplementation protocol.
  
  
  CONCLUSIONS
  A protocol of TMJ intra articular arthrocentesis and viscosupplementation improved cervical function and reduced disability in patients with concurrent cervical spine pain. These findings add to the complex amount of literature on the relationship between temporomandibular disorders and cervical spine disorders.
authors.affiliation: a TMD Clinic, Department of Neuroscience , University of Padua , Padova , Italy.|b Section of Dentistry and Maxillofacial Surgery , Hospital of Treviso , Treviso , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Guarda-Nardini
authors.affiliation: c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Cadorin
authors.affiliation: c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Frizziero
authors.affiliation: c Department of Physical and Rehabilitation Medicine , University of Padua , Padova , Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masiero
authors.affiliation: a TMD Clinic, Department of Neuroscience , University of Padua , Padova , Italy.|d School of Dentistry , University of Padova , Padova , Italy.
authors.forename: Daniele
authors.identifier: http://orcid.org/0000-0002-4352-3085
authors.initials: D
authors.lastname: Manfredini
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000503:physiopathology; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010003:Osteoarthritis / Q000503:physiopathology* / Q000628:therapy*; D016059:Range of Motion, Articular; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology* / Q000628:therapy*; D055675:Viscosupplements / Q000008:administration & dosage*
chemical_list: D055675:Viscosupplements; D006820:Hyaluronic Acid
keywords: Temporomandibular disorders; hyaluronic acid injections; neck pain; osteoarthritis; temporomandibular joint