Effects Of Jaw Muscle Pain On Jaw Muscle Activity And Jaw Movement In Humans
Funder
National Health and Medical Research Council
Funding Amount
$337,770.00
Summary
Chronic facial muscle pain is a significant community health problem that is poorly understood. Current treatments are based on the idea that structural or stress-related factors result in increased jaw muscle activity which then generates pain that in turn leads to more muscle activity - the so-called Vicious Cycle Theory. Treatments therefore aim to break the cycle by focussing on reducing muscle activity and thereby alleviate the pain. There is currently, however, little scientific evidence f ....Chronic facial muscle pain is a significant community health problem that is poorly understood. Current treatments are based on the idea that structural or stress-related factors result in increased jaw muscle activity which then generates pain that in turn leads to more muscle activity - the so-called Vicious Cycle Theory. Treatments therefore aim to break the cycle by focussing on reducing muscle activity and thereby alleviate the pain. There is currently, however, little scientific evidence for this Theory. Another theory has been recently proposed in the Pain Adaptation Model. This model says that changes in muscle activity and movement are protective against further pain rather than the cause of the pain. The evidence, however, for this model is limited and conflicting. The current lack of understanding of facial muscle pain limits advancement in its management. Our long-term goal is to improve the management of patients with facial pain. The present application aims to determine whether muscle pain alters jaw muscle activity and jaw movement. Our preliminary clinical data provide compelling evidence for the Pain Adaptation Model. We are confident of a better understanding of what goes wrong in the jaw muscles in chronic facial pain and this will have implications for muscle pains elsewhere in the body. The outcome may help to refute the Vicious Cycle Theory, and help shift the focus away from signs and symptoms associated with the jaw muscles, and re-direct the focus to the alleviation of pain as the primary management goal. The information obtained should also provide a solid basis on which treatments can be tested for optimal resolution of symptoms, and an evidence-based approach in the management of facial pain.Read moreRead less
Disruption And Restoration Of Motor Control In Musculoskeletal Pathology: Implications For Physiotherapy Management
Funder
National Health and Medical Research Council
Funding Amount
$210,990.00
Summary
The way in which the nervous system controls muscles and movement may play a role in the development and progression of common musculoskeletal conditions. One of these conditions is patellofemoral pain syndrome which is associated with pain around the knee cap. This condition may result from an imbalance in the activity of the thigh muscles that control movement of the knee cap as the knee bends and straightens. This imbalance is due in part to problems with the control of the muscles by the ner ....The way in which the nervous system controls muscles and movement may play a role in the development and progression of common musculoskeletal conditions. One of these conditions is patellofemoral pain syndrome which is associated with pain around the knee cap. This condition may result from an imbalance in the activity of the thigh muscles that control movement of the knee cap as the knee bends and straightens. This imbalance is due in part to problems with the control of the muscles by the nervous system. Our previous studies have shown that physiotherapy treatment aimed at restoration of the control of the knee muscles results in clinical improvement of the condition. The first part of this project will investigate possible reasons for this muscle imbalance including the effects of pain, swelling and muscle fatigue. Understanding the reasons for the imbalance in muscle activity will help direct and refine more appropriate treatment strategies for this and other musculoskeletal conditions. The second part will assess whether a specific physiotherapy muscle training program for the thigh muscles is more effective in correcting the muscle imbalance than a more generalised thigh strengthening exercise program. The results will help us to better understand why the condition occurs and how we can best assess and treat the problem.Read moreRead less
Pain changes movement. Although undisputed, there is a surprising lack of agreement regarding the underlying mechanisms. This project involves an innovative mix of neurophysiological methods to investigate the drive to muscle cells from the nervous system and changes in the mechanics of contraction. These studies will resolve the perplexing problem of how pain changes our ability to activate muscle. Clear understanding of the underlying mechanisms can guide rehabilitation.
Temporomandibular Disorders (TMD) are characterised by pain and limited jaw movement and are a significant issue. Current management is influenced by the view of a simple association between pain and limited movement. This study will test a new theory that an individual's motor response to pain is influenced by the complexity of the jaw motor system as well as the individual's pain experience. This project will point towards individualised recommendations for effective management of TMD.
An FMRI Analysis Of The Functional Organization Within The Brain Of Experimental Superficial And Deep Orofacial Pain
Funder
National Health and Medical Research Council
Funding Amount
$307,526.00
Summary
This project will investigate how the human brain processes a number of important aspects of human jaw muscle pain that are clinically relevant but poorly understood. For example, we do not understand why jaw muscle pain has such different behavioural effects to skin pain. Jaw muscle pain is associated with a significant emotional component not seen in with skin pains. Also, skin pain usually has a sharp or burning quality, is well-localized and is readily treated, while jaw muscle pain is a dee ....This project will investigate how the human brain processes a number of important aspects of human jaw muscle pain that are clinically relevant but poorly understood. For example, we do not understand why jaw muscle pain has such different behavioural effects to skin pain. Jaw muscle pain is associated with a significant emotional component not seen in with skin pains. Also, skin pain usually has a sharp or burning quality, is well-localized and is readily treated, while jaw muscle pain is a deep pain that has a dull, aching quality that may be referred to related sites of the face, head and neck. It is also not known why jaw muscle pain is more common in females in comparison to males. Chronic jaw muscle pain is a major symptom of patients with Temporomandibular Disorders, the most common form of non-dental orofacial pain and that involves pain in or about the jaw joint and-or jaw muscles, and often limitation of jaw movement. Chronic jaw muscle pain can have a severe effect on quality of life but its diagnosis and management is difficult. Despite the widespread prevalence of chronic orofacial pains, we have little information on the central processing of chronic human orofacial pain. This proposal will improve our fundamental understanding of how jaw muscle pain is processed in the brain. The way that the central nervous system processes and represents jaw muscle pain will help explain why these pains present differently in the clinic and should provide important information on the differences between females and males in the representation of jaw muscle pain. This information on the central processing of chronic orofacial pain is crucial to inform the direction of novel or specific management strategies. Our long-term goal is to improve the diagnosis and management of patients with Temporomandibular Disorders, and the present application represents a major new direction of research.Read moreRead less
Clinical Efficacy And Physiological Mechanisms Of Nerve And Tendon Gliding Exercises For Carpal Tunnel Syndrome
Funder
National Health and Medical Research Council
Funding Amount
$370,068.00
Summary
Compression of one of the major nerves at the wrist (carpal tunnel syndrome) is a very common condition that significantly impacts on the well-being of the patient. To date, there is no good evidence that traditionally advocated interventions are effective in the long term. This project will evaluate the effects of a novel, active treatment strategy and will investigate the underlying mechanisms that may be associated with exercises that aim to mobilise the nerve and tendons at the wrist.
Physical, Lifestyle And Psychosocial Determinants Of Spinal Pain Development In Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$682,800.00
Summary
This project aims to understand the development of back and neck pain in adolescence. By the age of 16 around half of all adolescents have suffered back pain and one third have suffered neck pain. For many adolescents this pain is disabling and over a third of sufferers miss school, miss recreation and seek medical help. The current understanding of back and neck pain in adolescence is quite limited - restricting the effectiveness of initiatives to prevent adolescents having to suffer spinal pai ....This project aims to understand the development of back and neck pain in adolescence. By the age of 16 around half of all adolescents have suffered back pain and one third have suffered neck pain. For many adolescents this pain is disabling and over a third of sufferers miss school, miss recreation and seek medical help. The current understanding of back and neck pain in adolescence is quite limited - restricting the effectiveness of initiatives to prevent adolescents having to suffer spinal pain and of treatment of those adolescents unlucky enough to have an episode. Better understanding and interventions for adolescent spinal pain will also have longer term implications by reducing adult spinal pain. Four out of 5 adults will experience spinal pain. In the USA treating adult back pain is the 4th largest health care cost. Many adults with chronic back pain had their first episode during adolescence. A better understanding of spinal pain in adolescence may help prevent it developing into a lifelong disability. We will collect information from 2,000 adolescents on their experience of back and neck pain and on potential physical, lifestyle and psychosocial risk factors. We believe factors such as their posture, muscle capacity, TV and computer use, mental health and social situation all combine to influence whether a person develops back or neck pain. The project is unique as it will not only collect a broad range of information during adolescence, but will also make use of a large database of health, developmental and psychosocial information already collected from these children since birth. With a better understanding of the development of spinal pain we will be able to develop guidelines to help prevent these problems. We will also be able to develop better treatment plans for sub-groups of adolescents with a particular combination of risk factors. Together these initiatives will assist in understanding and breaking the pathway to chronic spinal pain.Read moreRead less
This is a study of the senses which arise from our muscles and which tell us where our different body parts are, at any point in time. These senses, collectively called proprioception, are also involved in the automatic, unconscious control of our muscles. So, ultimately, they allow us to stand and to move freely with precision and confidence, even in the dark. One of these senses, the sense of effort or of heaviness, is believed to be generated within the brain. It intensifies when we become fa ....This is a study of the senses which arise from our muscles and which tell us where our different body parts are, at any point in time. These senses, collectively called proprioception, are also involved in the automatic, unconscious control of our muscles. So, ultimately, they allow us to stand and to move freely with precision and confidence, even in the dark. One of these senses, the sense of effort or of heaviness, is believed to be generated within the brain. It intensifies when we become fatigued. These experiments will be concerned with finding out more about how this works. We have a method that uses magnetic stimulation of the brain to change its control of our muscles. Using it we will learn how this sense is generated. When we close our eyes and move our limbs we realise that we know exactly where they are at any point in time. It remains uncertain exactly how this information is generated within the nervous system. One idea, arising from some recent experiments which we want to test, is that as we move the limb, the skin over the moving parts is stretched and stretch-sensitive nerve endings in the skin provide us with information about the movement. Alternatively, perhaps it is the effort we exert to maintain limb position against the force of gravity which tells us where the limb is. In another recent study we have found that when a muscle has become painful from excessive exercise or from some local strain injury, our ability to control the muscle and so move the limb is no longer as effective. We want to study the underlying nervous mechanisms responsible for the changes in movement control. Are they designed to spare the muscle while it recovers from injury? How are they brought about? All of this work is important for a better understanding of ourselves, for a better clinical diagnosis when something goes wrong and for improved treatment of diseased or injured muscles.Read moreRead less
Randomised Controlled Trial Of A Tailored Podiatry Intervention To Enhance Mobility And Prevent Falls In Older People
Funder
National Health and Medical Research Council
Funding Amount
$730,975.00
Summary
Foot problems affect 1 in 3 people over the age of 65 years and are associated with reduced walking speed, difficulty performing activities of daily living, impaired balance and increased risk of falls. Although a range of health professionals provide treatment for foot disorders, the most common chronic foot problems in older people (such as corns and calluses, nail disorders and toe deformities) are frequently managed by podiatrists using treatments such as scalpel debridement of lesions, foot ....Foot problems affect 1 in 3 people over the age of 65 years and are associated with reduced walking speed, difficulty performing activities of daily living, impaired balance and increased risk of falls. Although a range of health professionals provide treatment for foot disorders, the most common chronic foot problems in older people (such as corns and calluses, nail disorders and toe deformities) are frequently managed by podiatrists using treatments such as scalpel debridement of lesions, foot orthoses, exercise prescription and footwear modifications. The 1995 National Health Survey reported that persons aged 80 years or over were most likely to have reported visiting a podiatrist in the previous two weeks, followed by those aged 65-79 years. Similarly, the Australian Department of Veterans Affairs, which provides podiatry services to veterans and their dependants, documented 606,706 episodes of podiatry care to 103,540 veterans in 1998-1999, at a cost of $23M. Podiatry therefore plays a substantial role in the maintenance of foot health and mobility in older Australians. Despite the detrimental effects of foot problems and the widespread utilisation of podiatry services by older people, very few studies have been undertaken to ascertain the efficacy of podiatry treatments. Therefore, the aim of this study is to evaluate the efficacy of an individualised podiatry intervention designed to reduce pain, enhance functional mobility and prevent falls in older people. Given the high prevalence of foot-related disability and falls in older people and their associated health care costs, the study findings will be of considerable public health importance. If found to be clinically effective, the intervention could be easily implemented into a range of healthcare settings and adopted in both state and federal falls prevention policies.Read moreRead less