Letters to the Editor

Consider Atlanto-Occipital Joint Dysfunction as a Cause of Secondary Otalgia


Am Fam Physician. 2018 Aug 1;98(3):142.

Original Article: Ear Pain: Diagnosing Common and Uncommon Causes

Issue Date: January 1, 2018

See additional reader comments at: https://www.aafp.org/afp/2018/0101/p20.html

To the Editor: This comprehensive review indicates that temporal mandibular joint syndrome is a common cause of secondary otalgia. Another cause not mentioned in the article is atlanto-occipital joint dysfunction. Tenderness and restricted range of motion at this joint in a patient with otalgia suggests that atlanto-occipital joint dysfunction could be the cause. Treatment with osteopathic manipulative therapy can provide prompt relief of symptoms.1

Editor's Note: This letter was sent to the authors of “Ear Pain: Diagnosing Common and Uncommon Causes,” who declined to reply.

Author disclosure: No relevant financial affiliations.


1. Channell MK, Mason DC. The 5-Minute Osteopathic Manipulative Medicine Consult. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2009.

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This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



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