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"In order to gain knowledge, one should refrain from believing" - Leibnitz

cramps in the calf
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To correctly understand this heading:
Remember that any stressed person who continuously clenches his teeth can elicite remote pain and associated dyscomforts from teeth (which are not only painful organs but also tactile one like the thumb and the index in opposite situation)
If You are interested the scientifical data are shown lower.
idee.jpg Don't forget to consult the associated headlings : "Clinical Data" and "Witness and experience"



POSSIBLE PAINS :

- nape (mimicking arthrosis)
- superior limb (sometimes acroparesthesia)
- breast (upper-external quadrant)
- back, loins
- inferior limb (cramps in the calf)

Comment :

Important research about non-algic inputs that may come from teeth is surprising.

Since 1981 both RUGGIERO and some japanese authors enlightened, in the rat, that such an input might reach the medulla, the low-back and the paws of the animal.

Already 27 years ! (see references)

In 1991 MARFURT also proved that trigeminal inputs (so from constantly clenched teeth) might reach many zones of the nervous system (for more informations please see the §: Neurophysiology in this website)

Already 17 years ! (see references)

Let us be not surprised any more if a person who often clenches his or her teeth vainly complains about pains in the arms, cramps in the hands, cramps in the calves, pains in the back, sometimes pains in the lumbs.

Caution : if during the history the patient does not call up or admit the teeth clenching, this diagnosis chance must be simply ruled out.
The patient must consult again his physician. .











scientific data

abstEtComment.jpg
Some trigeminal sensitive roots which come from teeth connect their first synapse with the trigeminal subnucleus caudalis and so may contact the first cervical sensitive neurones : C1, C2, C3.
It may be considered that there is at this medullar level a "trigemino-cervical neuronal pool".
According to Delmas (Prof. of Anatomy in Paris University) there are special neuronal cells as called as "cordonal cells" which might connect together several medullar metameres since cervical level until sacral level. There the adjacent metameres are linked together so that any reflexe is plurisegmental. If the causal excitation is strong enough this kind of reflexe may diffuse all along the medulla until the sacral level.
These data enlighten the possible effect from a too strong and/or too durable stimulation against the previous "trigemino-cervical neuronal pool" and its far outcomes.
Here the effect is : pain in the leg.

This stimulation may come from a parafunctional teeth clenching, not from grinding.

Specific Biblio: - Marfurt CF, Rajchert DM (1991) Trigeminal primary afferent projections to "non-trigeminal" areas of the rat central nervous system. J Comp Neurol 303: 489-511
-Vinay L, Cazalets JR, Clarac F (1995) Evidence for the Existence of a Functional Polysynaptic Pathway From Trigeminal Afferents to Lumbar Motoneurons in the Neonatal Rat. Eup J Neurosci 7: 143-51

abstEtComment.jpg
Harden RN, Revivo G, Song S, Nampiaparampil D, Golden G, Kirincic M, Houle TT (2007) A critical analysis of the tender points in fibromyalgia. Pain Med 8; 2: 147-56

OBJECTIVE: To pilot methodologies designed to critically assess the American College of Rheumatology's (A.C.R.) diagnostic criteria for fibromyalgia.
DESIGN: Prospective, psychophysical testing.
SETTING: An urban teaching hospital.
SUBJECTS: Twenty-five patients with fibromyalgia and 31 healthy controls (convenience sample).
INTERVENTIONS: Pressure pain threshold was determined at the 18 ACR tender points and five sham points using an algometer (dolorimeter).
OUTCOME MEASURES: The patients "algometric total scores" (sums of the patients' average pain thresholds at the 18 tender points) were derived, as well as pain thresholds across sham points.
RESULTS: The "algometric total score" could differentiate patients with fibromyalgia from normals with an accuracy of 85.7% (P < 0.001). Even a single tender point had a diagnostic accuracy between 75% and 89%. Although fibromyalgics had less pain across sham points than across ACR tender points, sham points also could be used for diagnosis (85.7%; Ps < 0.001). Hierarchical cluster analysis showed that three points could be used for a classification accuracy equivalent to the use of all 18 points.
CONCLUSIONS: There was a significant difference in the "algometric total score" between patients with fibromyalgia and controls, and we suggest this quantified (although subjective) approach may represent a significant improvement over the current diagnostic scheme, but this must be tested vs other painful conditions. The points specified by the ACR were only modestly superior to sham points in making the diagnosis. Most importantly, this pilot suggests single points, smaller groups of points, or sham points may be as effective in diagnosing fibromyalgia as the use of all 18 points, and suggests methodologies to definitively test that hypothesis.

Comments : According to the previous data, fibromyalgia seems to remain a mysterious problem for clinicians.
We believe that any stressed fibromyalgic patient who strongly clenches may probably be a (TMD) case so that the fibromyalgia diagnosis may be reconsidered.
The test -therapy that we recommend will confirm or not the (TMD ) diagnosis.


Bibliography :

Clauzade M, Cardonnet M (1987) Diagnostic différentiel des dysfonctions de l’ATM. Cah Proth 58: 125-69

Clauzade M, Marty J-P (1998) Orthoposturodontie. SEOO (ed) Perpignan, 214 p

Clark GT, Browne PA, Nakano M, Yang Q (1993) Co-activation of sternocleidomastoid muscles during jaw clenching. J Dent Res 72, 11: 1499-502

De Laat A, Meuleman H, Stevens A, Verbeke G (1998) Correlation between cervical spine and temporomandibular disorders. Clin Oral Investig 2; 2: 54-7

De Wijer A, Steenks MH, De Leeuw J, Bosman F, Helders PJ (1996) Symptoms of the cervical spine in temporomandibular and cervical spine disorders. J Oral Rehabil 23: 742-50

Ehrlich R, Garlick D, Ninio M (1999) The Effect of Jaw Clenching on the Electromyographic Activities of 2 Neck and 2 Trunk Muscles. J Orofac Pain 13, 2: 115-20

Jaïs L (1995) Dysfonction craniomandibulorachidienne et Spine Craniomandibular Ubiquitary Dystonic Dyslateralisation Disorder (SCUDd). In: Gagey PM, Weber B. Entrées du système postural fin. Masson (ed) Paris, pp 88-116

Marfurt CF, Rajchert DM (1991) Trigeminal primary afferent projections to "non-trigeminal" areas of the rat central nervous system. J Comp Neurol 303: 489-511

Matsushita M, Okado N, Ikeda M, Hosoya Y (1981) Descending projections from the spinal and mesencephalic nuclei or the trigeminal nerve to the spinal cord in the cat. A study with the horseradish peroxydase technique. J Comp Neurol 196: 173-87

Meyer J, Baron JB (1976) Participation des afférences trigéminales à la régulation tonique posturale. Aspects statique et dynamique. Agressol 17 (A): 33-40

Miyahara T, Haglya N, Ohyama T, Nakamuna Y (1996) Modulations of human soleus H-reflexes in association with voluntary clenching of the teeth. J Neurophysiol 76: 2033-41

Molina OF, Dos Santos J, Nelson SJ, Grossman E (1997) Prevalence of Modalities of Headaches and Bruxism Among Patients With Craniomandibular Disorder. J Craniomandib Pract 15; 4: 314-25

Molina OF, Dos Santos J, Mazzetto M, Nelson S, Nowlin T, Mainieri ET (2001) Oral Jaw Behaviors in TMD and Bruxism: A Comparison Study by Severity of Bruxism. J Craniomandib Pract 19; 2: 114-22

Palazzi C, Miralles R, Soto MA, Santander H, Zuñiga C, Moya H (1996) Body position effect on EMG activity of sternocleidomastoid and masseter muscles in patients with myogenic cranio-cervical-mandibular dysfunction. J Craniomandib Pract 14; 3: 200-9

Ruggiero DA, Ross ChA, Reis DJ (1981) Projections from the spinal trigeminal Nucleus to the entire length of the spinal cord in the rat. Brain Res 225: 225-33

Travell JG, Simons DG (1983) Myofascial pain and dysfunctipon. The Trigger-Point Manual. Williams & Wilkins (ed) Baltimore, 713 p

Vinay L, Cazalets JR, Clarac F (1995) Evidence for the Existence of a Functional Polysynaptic Pathway From Trigeminal Afferents to Lumbar Motoneurons in the Neonatal Rat. Eup J Neurosci 7: 143-51

Last Updated on Thursday, 21 May 2015 00:17
 
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