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Temporomandibular joint disorder (TMD) is an organizational term that is used to describe pain and discomfort associated with mastication. The discomfort itself is centered within the jaw muscles, but the face, neck, and head are also likely to be affected. The condition has typically been treated by dental professionals, orthodontists, and psychologists. Traditional treatment techniques are likely to include the following:
Professionals agree that none of these techniques are completely effective on their own, and examinations of related postural abnormalities may offer a viable avenue forward.
Recent studies have shown that forward head posture (FHP) may be linked to facial pain. When individuals slump forward, they are ultimately causing their shoulders to become more rounded. This moves the head to an anterior position that is beyond the traditional resting location. The spinal muscles react in a way that alters the resting position of the mandible, thus leading to the pain that is traditionally associated with the condition.
In addition to pain in the jaw, individuals with FHP can also experience issues with the support structures in the lower half of the body. Patients might even be more at risk of developing injuries that are more commonly associated with highly active individuals. These may include the following:
The best way to avoid these problems is with a rigorously designed exercise program overseen by specialists within the field.
A number of exercises can bring the occiput and the cervical spine into alignment. The primary goal is to reduce torque within the neck and shoulders while also reducing load on the musculature of the upper spine. When the shoulder, the scapula, and the thorax are brought into alignment, the stress on the cervical column itself will become normalized. A recognition of the role that posture plays in creating and enhancing facial pain is crucial to the treatment of the discomfort. Regular therapeutic sessions with specialized alignment devices should reduce pain and allow for a higher quality of life, especially among those patients who have suffered from restricted mandibular movement for many years.
Weaknesses within the musculature of the spine can cause FHP. These weaknesses are caused by a number of factors, including the following:
Because hunching of the shoulders is so common, the reconditioning of the target muscles can have a number of benefits. With regular use of a special apparatus, most men and women should be able to strengthen their muscles and thus improve their posture. Gradual posture correction will help with discomfort that is located in the jaw, back, neck, and head. In fact, many individuals may even find that they feel better when performing tasks that strain the spinal muscles, such as sitting at a keyboard for eight hours.
Individuals who work to correct their posture will ultimately notice both physical and psychological benefits. In addition to the amelioration of physical pain that is so often associated with temporomandibular joint disorder, people will also notice a more robust state of mind and perhaps even an increase in self-esteem. A reintroduction to all of the finer things in life can then be enjoyed once again.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.
A bad physical therapy experience is one of the primary causes of unnecessary surgery
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
