Thursday, January 5, 2017

PT Pathologies - TMJ Disorder

As a Physical Therapist Student, we are tasked in our Pathology class  to read up on various diseases.  In order to demonstrate our understanding we create brief reports detailing the pathology and how physical therapy can help.  I will post these every week or two as I work my way down the list of pathologies.  Please use these posts to understand pathologies from the perspective of a therapist.

Temporomandibular joint disorder, or dysfunction, (TMD) is a common condition that restricts the normal functions of the jaw, such as opening the mouth and chewing. It currently affects more than 10 million people in the US. The (TMJ) is a hinge joint that connects your jaw to your skull in front of your ear. The TMJ directs jaw movement and allows you to open and close your mouth and move it from side to side to communicate, make sounds, sneeze, cough, yawn, or chew. A primary cause of TMD is grinding of the teeth, which can take place when stressed or while sleeping. It can also be caused by trauma to the head or neck such as in a whiplash injury, by malocclusion of the teeth and other dental and anatomic abnormalities, and by arthritis and osteoarthritis. Poor posture can also cause TMD because awkward position of the jaw when chewing, swallowing, and speaking will cause stress to the joint.

An assortment of symptoms may be linked to TMJ disorders. Pain, particularly in the chewing muscles & jaw joint, is the most common warning sign. Other signs consist of: jaw stiffness, headaches, vague tooth soreness which often move around the mouth, sensitive teeth, tender jaw, difficulty opening mouth, and clicking sounds. Your physical therapist will evaluate your posture and observe how your cervical spine moves and examine your TMJ to find out how well it functions and whether there are any abnormalities in your jaw motion. If the PT suspects that your pain is a result of the alignment of your teeth, the therapist will refer you to your dentist for further examination. Management of TMD, however, most often involves a multidisciplinary approach. Dentists, orthodontists, psychologists, physical therapists, and physicians work together to address the condition of the patient with TMD.

Physical therapy is anticipated to alleviate musculoskeletal pain, reduce inflammation, and restore oral motor function. Many physical therapy interventions are potentially effective in managing TMD, including massage, exercise, and manual therapy techniques. Electric stimulus modalities include interventions such as ultrasound, laser, and transcutaneous electrical nerve stimulation. Physical therapy interventions often include therapeutic exercises for the masticatory or cervical spine muscles to improve strength and mobility in the area. Manual therapy techniques are commonly used to reduce pain and restore mobility.

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