Temporomandibular Joint Disorder
Physical Therapies
Physical therapy (PT) is a common conservative treatment for TMD. It can help decrease pain and inflammation, promote repair of injured tissues and help you get your normal jaw function back. PT for TMD may include a combination of manual therapy, exercises and modalities.
Manual therapy is done by a physical therapist to help decrease pain and restore jaw movement. Techniques to move the jaw may be helpful for people with decreased range of motion and pain related to jaw muscle contracture, disc displacement and adhesion in the joints. Often a patient will take pain relievers and do muscle relaxation techniques before these types of manual therapy are done.
Exercises can be done during a PT appointment and/or at home. They may help to improve muscle and joint function, strength and coordination, range of motion and stability of the TMJs. Exercises may involve the muscles in your face, tongue, jaw, neck and upper shoulders. Examples of exercises may include lateral and protrusive jaw movement, resisted opening and closing and posture training. You may also be given an oral exercise device to do passive stretching exercises. Ask your therapist how many times per day you should do your home exercises.
You may have one or more of the following modalities:
Manual Therapy
Manual therapy is done by a physical therapist to help decrease pain and restore jaw movement. Techniques to move the jaw may be helpful for people with decreased range of motion and pain related to jaw muscle contracture, disc displacement and adhesion in the joints. Often a patient will take pain relievers and do muscle relaxation techniques before these types of manual therapy are done.
Exercises
Exercises can be done during a PT appointment and/or at home. They may help to improve muscle and joint function, strength and coordination, range of motion and stability of the TMJs. Exercises may involve the muscles in your face, tongue, jaw, neck and upper shoulders. Examples of exercises may include lateral and protrusive jaw movement, resisted opening and closing and posture training. You may also be given an oral exercise device to do passive stretching exercises. Ask your therapist how many times per day you should do your home exercises.
Modalities
You may have one or more of the following modalities:
- Iontophoresis – A specially-prepared medicine such as steroid cream is placed on two electrodes (flat patches with a wire attached to each). The patches are placed on the skin over the painful area, and the wires are plugged into a small machine. When the machine is turned on, it sends a tiny, safe amount of electric current through each electrode. The current pushes or “injects” the medicine into the skin and deeper tissues to help decrease pain and inflammation.
- Phonophoresis – Medicine such as steroid cream is rubbed into the skin and covered with a dressing. Sound waves from an ultrasound machine help push or “inject” medicine into the skin and deeper tissues to decrease pain and inflammation.
- Electrotherapy – Electrotherapy is a term that represents a number of treatments. Electrotherapy is done to increase circulation in the joint, relax face and jaw muscles and relieve pain. Examples of electrotherapy for TMD include TENS, electrogalvanic stimulation (EGS) and microcurrent.
- Laser, ultrasound or radio frequency energy therapies – These therapies focus beams of heat, sound or radio waves into the TMJ to increase blood flow and relieve pain. These may be done in a series of treatments or during a physical therapy session to ease pain during your manual therapy and exercise. Laser and radiofrequency energy therapies are sometimes helpful, but research results show that the benefit is unproven and unpredictable.
- Heat or cold therapy – You may apply heat and/or cold packs to your jaw before and after exercises to relax your joint and muscles. You may also use heat and cold therapy during other times of the day for pain relief.
- Spray and stretch – Before stretching and massage, you may apply moist heat followed by a topical anesthetic such as vapocoolant spray or another topical pain reliever.