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Abstract: Chronic nonspecific neck pain is a common problem in rheumatology and may resist conventional treatment. Pathophysiological links exist between the cervical spine and masticatory system. Occlusal disorders may cause neck pain and may respond to dental treatment. The estimated prevalence of occlusal disorders is about 45%, with half the cases being due to functional factors. Minor repeated masticatory dysfunction (MD) with craniocervical asymmetry is the most common clinical picture. The pain is usually located in the suboccipital region and refractory to conventional treatment. The time pattern may be suggestive, with nocturnal arousals or triggering by temporomandibular movements. MD should be strongly suspected in patients with at least two of the following: history of treated or untreated MD, unilateral temporomandibular joint pain and clicking, lateral deviation during mouth opening, and limitation of mouth opening (less than three fingerbreadths). Rheumatologists should consider MD among causes of neck pain, most notably in patients with abnormal craniocervical posture, signs linking the neck pain to mastication, and clinical manifestations of MD. Evidence suggesting that MD may cause neck pain has been published. However, studies are needed to determine whether treatment of MD can relieve neck pain. [Copyright &y& Elsevier]

Objective. – To assess the sensitivity to change of three algo-functional scales for neck pain.Methods. – Observational, prospective study. Patients with neck disorders were included. Pain and patients’ perceived handicap were assessed on visual analog scales (VAS Pain, VAS Handicap), and functional disability measures (Neck Disability Index, Neck Pain and Disability Scale, Northwick Park Neck Pain Questionnaire) were recorded twice, at baseline and at an 11-months follow-up assessment. Sensitivity to change was assessed using the effect size (ES) and the standardised response mean (SRM), and the non parametric Spearman rank correlation coefficient (r) was used to assess the correlation between quantitative variable changes and patients’ overall opinion. Analysis of variance (ANOVA) followed by a Tukey test were performed to determine if the scales distinguished improved, stable, and deteriorated patients.Results. – Seventy-one patients (43 women, mean age 49 years) were included and evaluated twice at an interval of 11 ± 2 months. The three scales showed good sensitivity to change. The ANOVA showed a group effect, and individual changes in the scales scores were statistically different in two-by-two comparisons (improved, stable or deteriorated patients). Changes in NPDS scores had the highest correlation with patient’s overall assessment (r = 0.592).Conclusion. – The three scales can detect changes in patients with neck disorders. Changes in NPDS score had the best correlation with patients’ overall opinion concerning their neck disorder and this questionnaire should be given preference in clinical trials. [Copyright &y& Elsevier]