Forward Head Posture and Myogenic TMD Association in Smartphone Overuse

Correlation Between Forward Head Posture And Myogenic Temporomandibular Disorder In Addicted Smartphone Users

The goal of this observational study is to determine the correlation between forward head posture and myogenic temporomandibular disorder, pain pressure threshold and endurance of masticatory and neck muscles in addicted smart phone users. The main question it aims to answer is:

• What is the correlation between forward head posture and myogenic temporomandibular disorder, pain pressure threshold and endurance of masticatory and neck muscles in addicted smart phone users?

Temporomandibular joint (TMJ) and cervical spine are closely related to each other due to their anatomical, mechanical and neurophysiological relationships. That's why pain and dysfunction in the cervical spine can be observed in patients with temporomandibular disorders (TMD) who may suffer from clinical problems in the masticatory muscles, the temporomandibular joint and other associated structures.

Millions of people worldwide use their smartphone devices excessively. Prevalence of smartphone addiction among Egyptian university students was 62.4% revealing that females had a higher addiction than men. This excessive use where subjects downwardly flex their neck to enable them to look at the screen, affects head and neck postures leading to forward head posture (FHP) which consequently alters the position of the mandible along with its functions, resulting in an increase tension in the masticatory muscles causing TMD. Addicted smartphone users contribute to changes in craniocervical region which led to myogenic TMD in young teenagers.

Pain, tenderness in masticatory muscles and cervical muscle endurance are common clinical findings in patients with TMD; where muscle tenderness is reduced and cervical muscle endurance was found to have a shorter duration holding time when performing neck extensor endurance test due to higher fatigability of neck extensor muscles.

Inclusion Criteria:

1. Subject's age range from 18 - 40 years.
2. Both males and females will be recruited.
3. Subjects diagnosed as myogenic TMD according to the presence of trigger points in masseter, temporalis, upper trapezius and C5-C6 articular pillars according to the myofascial diagnostic criteria that includes a taut band and hypersensitive spot
4. All subjects are heavy smartphones users, using the SAS-SV, the cuffof value for males is 31 and for females is 33.
5. All subjects will have forward head posture assessed by CVA less than 49.9 degrees.

Exclusion Criteria:

1. History of head, neck or TMJ trauma
2. Patients who underwent orthodontic treatment
3. Congenital, or acquired postural deformity
4. No previous neck or spinal or TMJ surgery
5. Subjects who are on anti-inflammatory or analgesic drugs for pain