Temporomandibular joint disorders (TMJD) include temporomandibular joint dysfunction and bruxism. Sacroiliac joint dysfunction (SJD) is a frequent cause of non-discogenic low back pain. Studies suggest a relationship between TMJD and SJD; however, the link remains unclear. Neural therapy (NT) utilises local anaesthetic injections to treat pain by normalising a dysfunctional autonomic nervous system held responsible for initiating or propagating chronic pain. A 31-year-old female presented with a 1-year history of mechanical left-sided low back pain and sleep bruxism. Examination revealed crepitation of the left TMJ and a trigger point in the masseter muscle. Range of motion of the spine and hip joints were normal, Patrick and Geanslen tests were positive on the left side. Spine and standing flexion tests were also positive. Magnetic resonance imaging of the lumbar spine and sacroiliac joints were normal. A diagnosis of SJD was made, and the patient was treated using NT. Injections of lidocaine 0.5% to the left TMJ, the masseter muscle and intradermal segmental injections at the level of C4 were administered. The patient’s back pain and TMJ tenderness reduced and continued so throughout the 3-month follow-up period. SJD may be related to TMJD, and NT may be used in its treatment.

1.
de Leeuw
R
,
Klasser
GD
.
Orofacial pain: guidelines for assessment, diagnosis, and management, American Academy of Orofacial Pain
. 6th ed.
Chicago
:
Quintessence Publishing Co
;
2018
.
2.
Von Korff
M
,
Dworkin
SF
,
Le Resche
L
,
Kruger
A
.
An epidemiologic comparison of pain complaints
.
Pain
.
1988
Feb
;
32
(
2
):
173
83
.
[PubMed]
0304-3959
3.
Bond
EC
,
Mackey
S
,
English
R
, et al.
Temporomandibular Disorders: Priorities for Research and Care. Report
.
USA
:
The National Academies of Sciences, Engineering, and Medicine
;
2020
.
4.
Jiménez-Silva
A
,
Peña-Durán
C
,
Tobar-Reyes
J
,
Frugone-Zambra
R
.
Sleep and awake bruxism in adults and its relationship with temporomandibular disorders: A systematic review from 2003 to 2014
.
Acta Odontol Scand
.
2017
Jan
;
75
(
1
):
36
58
.
[PubMed]
0001-6357
5.
Cacchiotti
DA
,
Plesh
O
,
Bianchi
P
,
McNeill
C
.
Signs and symptoms in samples with and without temporomandibular disorders
.
J Craniomandib Disord
.
1991
;
5
(
3
):
167
72
.
[PubMed]
0890-2739
6.
Kiapour
A
,
Joukar
A
,
Elgafy
H
,
Erbulut
DU
,
Agarwal
AK
,
Goel
VK
.
Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain
.
Int J Spine Surg
.
2020
Feb
;
14
(
s1
Suppl 1
):
3
13
.
[PubMed]
2211-4599
7.
Fink
M
,
Wähling
K
,
Stiesch-Scholz
M
,
Tschernitschek
H
.
The functional relationship between the craniomandibular system, cervical spine, and the sacroiliac joint: a preliminary investigation
.
Cranio
.
2003
Jul
;
21
(
3
):
202
8
.
[PubMed]
0886-9634
8.
Gregory
TM
.
Temporomandibular disorder associated with sacroiliac sprain
.
J Manipulative Physiol Ther
.
1993
May
;
16
(
4
):
256
65
.
[PubMed]
0161-4754
9.
Chinappi
AS
 Jr
,
Getzoff
H
.
Chiropractic/dental cotreatment of lumbosacral pain with temporomandibular joint involvement
.
J Manipulative Physiol Ther
.
1996
Nov-Dec
;
19
(
9
):
607
12
.
[PubMed]
0161-4754
10.
Frank
BL
.
Neural therapy
.
Phys Med Rehabil Clin N Am
.
1999
Aug
;
10
(
3
):
573
82
.
[PubMed]
1047-9651
11.
Cibulka
MT
,
Koldehoff
R
.
Clinical usefulness of a cluster of sacroiliac joint tests in patients with and without low back pain
.
J Orthop Sports Phys Ther
.
1999
Feb
;
29
(
2
):
83
9
.
[PubMed]
0190-6011
12.
Toussaint
R
,
Gawlik
CS
,
Rehder
U
,
Rüther
W
.
Sacroiliac joint diagnostics in the Hamburg Construction Workers Study
.
J Manipulative Physiol Ther
.
1999
Mar-Apr
;
22
(
3
):
139
43
.
[PubMed]
0161-4754
13.
Weinschenk
S
.
Neural therapy - A review of the therapeutic use of local anesthetics
.
Acupuncture and Related Therapies
.
2012
;
1
(
1
):
5
9
.
14.
Egli
S
,
Pfister
M
,
Ludin
SM
,
Puente de la Vega
K
,
Busato
A
,
Fischer
L
.
Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients
.
BMC Complement Altern Med
.
2015
Jun
;
15
(
1
):
200
5
.
[PubMed]
1472-6882
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