Temporomandibular joint disorder (TMD) causes pain when patients open their mouths or chew their food. According to the American Chiropractic Association, the leading cause of TMD is severe injury to the jaw, like an auto injury or a hit to the face during sporting activities.
Patients with TMD have a variety of treatment options. Many physical therapists and doctors of chiropractic recommend intra-oral myofascial therapies (IMT), such as “trigger point releases”. Other patients are advised about self-care to heal TMD, and are given education about how to exercise their jaw.
In a recent study, researchers compared the efficacy of IMT to education, self-care, and exercise. They analyzed the differences each made to short-term outcomes in pain and mouth opening range for TMD patients.
The research team recruited 46 participants with chronic TMD, and randomly assigned each person into either an IMT group or an education group. All patients received two sessions per week for five weeks of their selected treatment. The IMT group’s treatment consisted of several myofascial techniques, including manual therapy like chiropractors often use to treat TMD patients. Manual techniques included intra-oral temporalis release, intra-oral medial and lateral pterygoid technique, and intra-oral sphenopalatine ganglion technique. The education consisted of short talks on topics such as the anatomy and biomechanics of the jaw, in addition to instruction and supervision of self-care exercises.
Participants self-reported their pain, using a pain scale, before and after treatment, including pain at rest and pain upon opening and clenching the jaw. The range of motion for opening the mouth was also measured for each patient.
The study’s findings showed that the IMT group had significantly lower average jaw pain than the education group. While both groups experienced decreased pain after five weeks of treatment, only the IMT group achieved clinically significant decreases in pain scores. The study found no significant difference in mouth-opening range between the two groups.
The authors of the study concluded that positive changes over time for both treatment protocols were noted. However, their findings showed “evidence of superiority of IMT” compared to education about self-care exercise.
These results confirm previous research highlighting the effectiveness of chiropractic techniques for easing TMJ pain, and another study highlighting the efficacy of manual therapy in particular for TMD.
American Chiropractic Association. Temporomandibular joint disorder. Patient resources: www.acatoday.org.
Kalamir A, Graham P, et al. Intra-oral myofascial therapy versus education and self-care in the treatment of chronic, myogenous temporomandibular disorder: a randomised, clinical trial. Chiropractic & Manual Therapies 2013; 21: 17. doi:10.1186/2045-709X-21-17.