Temporomandibular disorders (TMD) involve pain and dysfunction around the TMJ (your jaw) and jaw muscles. The National Instititue of Dental and Craniofacial Research performed a 3 year study to identify biopsychosocial and genetic risk factors in the development of TMD. Potential risk factors for first-onset TMD were identified with older age, African American, pain on jaw opening and palpation tenderness of head and neck muscles, increased incidence of other regional pain conditions including low back pain and irritable bowel syndrome, other nonspecific comorbid conditions including fibromyalgia and depression, and lower overall quality of life and health status. Systematic reviews have repeatedly supported instruction in a self-management strategy including education, resting during pain, relaxation techniques, massage, hot and/or cold packs, and stretching and/or exercise. Did you know there were exercises for your jaw? Yes, there are! Use of medication and splints has not been found in the literature to be effective in decreasing pain and dysfunction from TMD. Conservative treatment with a home program has the best results found in multiple systematic reviews.
Now, headaches are a bit more complicated tale to tell because there are different types of headaches with different findings in the research. Migraines are primarily managed with pharmacological agents. Physical therapy can be beneficial if included with relaxation and biofeedback treatments. Cluster type headaches are very rare and, therefore, there is little research on the effectiveness of physical therapy with this diagnosis. Tension-type headaches are effectively treated with physical therapy which involves education regarding posture and biomechanics, an exercise program aimed at improving posture of the cervical spine, and manual therapy to reduce muscle tension.
Seventeen years of clinical experience tells me that tension type headaches respond really well to physical therapy. Migraine intensity, duration, and frequency can be dramatically altered with physical therapy. The one cluster type headache patient I saw had a significant decrease in intensity and frequency of his headaches.
If you would like to discuss your TMD or headache symptoms, please feel free to contact Amy at (425)658-4944 or amykonvalinpt@gmail.com.