Guest Editorial: Treating Myofacial and Other Idiopathic Head and Neck Pain
by Mark Duncan, DDS, FAGD, DICOI, LVIF
There are a number of different issues that come to rise in both the physician’s
office and the dental practice. One that has surfaced is the prevalence and subsequent
treatment of head and neck pain. The problem is that, for people who suffer with such
pain, there has been little that can be done to help remedy the problem and patients go
through a fairly typical pathway ultimately feeling that there is little to no hope.
Throughout time, headaches have plagued people and various solutions have been tried and
abandoned. Despite advances in modern healthcare, real answers still do not exist for a
number of problems our patients deal with.
It would not be appropriate to claim a panacea for multi-factorial issues or to promote
a singular approach of treating every collection of symptoms that hints at head and neck
pain, however there are some incredibly interesting developments in the field of dentistry
that would be of major benefit to the primary care physicians and those who deal with
issues of pain in the head and neck. It is analogous to the story of several blind people
who each described an elephant. Since none could see the whole elephant, their impression
of what an elephant looks like was totally dependent on the picture in their mind’s
eye based on what they feel. The man feeling the tail, the one feeling the leg, the one
feeling the belly, and the one feeling the trunk will see, in their mind’s eye, a
very different animal. And so it is with pain in the head and neck.
This would not be an issue if patients were not still dealing with pain, however the
incidence of migraine in the United States is just a little over 10% and the incidence of
headache is over 15%. Together that is more than one in four people who are dealing with
significant pain and discomfort. As the pain of those patients becomes severe enough that
they seek help, they go to the only logical provider—their physician. In many cases,
there is some benefit in following advice, managing allergies, controlling food intake or
supporting the patient with medication. The interesting thing that has come to light
recently is the benefit of support from a dentist who understands and employs physiologic
support of comfortable muscles. As a physician treating chronic pain in the head and neck,
it is unlikely that the concepts of neuromuscular dentistry will fall into the realm of
training. Unfortunately, even most dentists have not been exposed to the neuromuscular
approach. Nevertheless, there are a number of dentists around the world who are employing
these concepts in the evaluation of their patients and are experiencing excellent results.
With this track record of success, it is time to share the benefits of our various
perspectives so that we can accurately describe the complete picture and finally get these
patients some help.
Please refer to the May 2010 issue for the complete text. In the event you need to order a back issue, please click here.
— May 2010
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