RUNNING ON SUNSHINE PHYSICAL THERAPY
Christen Thieman, PT, DPT, OCS
In a Nutshell
Temporomandibular Disorder, also known as TMD or jaw pain, is a condition that may be treated in physical therapy.
The Issue
While perhaps the least contemplated joint, the temporomandibular joint is cited as the most used joint in the body during daily activity. It is essential for swallowing, speaking, and chewing. The temporomandibular joint, also known as the TMJ, has unique features, though it is a synovial joint like many other joints in the body. It is made up of several bones of the jaw, though most famously known for its two major contributors, the 'temporal' bone and the 'mandible', hence its creative naming.
Presence of trauma, disease, overuse, stress, and behaviors such as jaw clenching and mouth breathing are examples of factors that can affect the movement patterns of the TMJ and may result in pain and dysfunction. Pain may result if there is limited mobility at the TMJ. TMJ pain may also occur if excessive mobility, known as hypermobility, is present. The TMJ is significantly affected by the function and positioning of the neck and upper quadrant of the body. The cause of TMJ disorder (TMD) is frequently multifactorial. TMD has the potential to cause not only jaw pain and clicking, but it also can be associated with headaches, ear symptoms, dizziness, speech difficulty, and at times, tooth pain that can be referred from the jaw. While patients with TMD are considered a niche population, literature cites that 50-75% of people experience at least one symptom of TMD at some point in time.
The Opportunity
The good news is that patients with TMD are excellent candidates for physical therapy treatment! Treatment of patients with TMD is often comprehensive, and along with physical therapy, it frequently includes providers, dentists, and behavioral health specialists. Physical therapy examination is important to ensure that patients are appropriate for physical therapy, and differential diagnosis is used to identify the cause of jaw pain as well as the factors that may have contributed to its occurrence.
Based on the findings of the examination, physical therapy treatment is patient-specific and often multifaceted. Treatment includes exercise strategies that are designed to improve the mobility, stability, and/or motor control of the TMJ. Development of appropriate posture and avoidance of a forward head posture are paramount to the TMJ functioning well. Patient education may also include instruction on sleeping posture, proper tongue resting posture, and breathing patterns. Manual therapy is an effective component of care. It is exciting that studies support not only statistically significant but also clinically meaningful improvements in patients’ TMD symptoms when they are involved in physical therapy care!
Reference
Ho S. The temporomandibular joint: physical therapy patient management utilizing current evidence. Current Concepts of Orthopaedic Physical Therapy, 3 rd ed. Independent Study Course 21.2.5. APTA.
Christen Thieman, PT, DPT, OCS
Christen holds a doctorate in physical therapy and has practiced since 2009. She is board-certified as an Orthopedic Clinical Specialist. She founded RUNNING ON SUNSHINE PHYSICAL THERAPY. In earlier times, she spearheaded an evidence-based practice committee and presented research findings to the physical therapy department as well as the organization at large. Christen is grateful for the tremendous opportunity to learn not only from colleagues and literature, but also from her patients and views them as treasured collaborators.
Please feel free to contact RUNNING ON SUNSHINE PHYSICAL THERAPY with any questions, insights, or suggestions and to schedule an appointment.
RUNNING ON SUNSHINE PHYSICAL THERAPY
120 Bishops Way, Suite 154, Brookfield, WI 53005
414.702.2780
This information is for educational purposes only and is not intended as medical advice. Please consult your physician and/or physical therapist directly for specific recommendations regarding your care.