Temporomandibular Disorder (TMD)

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Description

Temporomandibular disorder (TMD) results from impaired mechanics in your jaw due to issues related to your muscles or TM joint. It can start off only as a muscular issue that, if left unaddressed, can lead to longstanding degenerative changes in your jaw joint.

  • Common Complaints: Popping or locking in the jaw, muscle tension, limited mouth opening, pain with jaw clenching or eating that progresses to resting jaw pain.

  • Common Conditions Associated: Tension headaches, whiplash, fibromyalgia, tinnitus (ringing in the ear), vertigo, impaired hearing, ear pain, poor postural awareness.

  • Classifications:

    • Type 1: Muscle disorders (mainly the lateral pterygoid muscle) typically from overuse or muscle guarding.

    • Type 2: Disc displacement with or without reduction. A worsening of the muscle condition but includes the joint disc. An abnormal dis shape and/or change in the joint capsule that causes the disc to move abnormally can lead to the “popping” symptoms many people report.

    • Type 3: Joint degeneration, a worsening of the pain from the arthritic and degenerative changes in the joint and muscle tissue due to impaired joint mechanics.


Research

Research has shown that for the reduction of pain and disability in TMD, physical therapy, including joint mobilization to the TMJ and neck, as well as dry needling to the lateral pterygoid muscle are the most effective treatments.

  • References: Pathoanatomical Characteristics of Temporomandibular Dysfunction: Where do we stand? Part 1 (Butts et all 2017a). Conservative Management of Temporomandibular Dysfunction: a literature Review with Clinical Practice Guidelines (Butts et all 2017b).


Treatment

  • Typical duration: Average 4-8 weeks, 2 times a week, approx 30-minute sessions.

  • Type: Dry needling, manual therapy including joint mobilization (TMJ) and cervical spine, exercises for postural correction, and education and relaxation techniques.