Temporomandibular disorder involves dysfunction in the masticatory (chewing) muscles, TMJ, and associated structures. There are three common categories of TMD: myogenic (muscle dysfunction), arthrogenic (joint dysfunction), or mixed (which is the most common). Some common causes of dysfunction include previous trauma, mal-occlusion, parafunctional habits (teeth grinding, nail biting, gum chewing, etc), poor posture, stress, and post dental procedure or surgery.
In many cases, symptoms of TMD are caused by a combination of the reasons listed above. Common signs and symptoms reported by patients include: jaw pain, neck pain, headache, clicking when opening or closing mouth, limited mouth opening, or limited mouth closing (lock jaw). Once the source of pain is determined, the therapist is better able to determine the best course of treatment. Treatment techniques may involve: trigger point release and soft tissue mobilization of tense muscles (usually jaw closing muscles), strengthening of weak muscles, postural correction, joint mobilization (ensuring that the jaw is positioned correctly and moving properly during mouth opening and closing), relaxation techniques, modalities (for management of pain and inflammation), neuromuscular re-education, and patient education.
The plan of care is carefully determined by the therapist to best match the signs and symptoms that each patient presents with to provide them with maximum relief and functioning. Because the cervical spine is so closely connected to the TMJ and masticatory musculature, neck pain and dysfunction is a common comorbidity. Therefore, treatment techniques usually encompass the evaluation and treatment of the neck as well.