Jaw pain and TMJ: Treatment details, Part b


Jaw pain, Muscle information, Neuromuscular therapy, Tips for therapists, TMJ pain / Friday, September 4th, 2009

This is a series on jaw pain and TMJ. If you missed the beginning, go back to part 1 following which you’ll find a case study, muscle information, treatment notes and a Neuromuscular Therapist’s thoughts.

When I saw Rodney D. a week after his second Neuromuscular Therapy treatment in our Boston area clinic, he said he felt a dramatic improvement. His jaw was 80% better! He reported that when he first starts chewing, it hurts, but it loosens up after a few bites. He felt sore after the treatment at the zygomatic arch of his cheekbone (lateral pterygoid and masseter) and at the back angle of his jaw (medial pterygoid), but said his teeth were almost lining up at last!

This third treatment I went inside his mouth to be more specific in treating the masseter and the medial and lateral pterygoid muscles. They were all three very painful. Going back to the previous treatment procedure protocol, I repeated a thorough treatment of the suboccipitals, SCM, longissimus capitis, and temporalis muscles.  I also worked below the zygomatic arch where he had felt post-treatment soreness in the masseter attachment and the deeper lateral pterygoid, and above the arch to address part of the temporalis.

Rodney had two more massage appointments for other complaints before I saw him again. He reported at his fourth NMT session that he still had a little pain in his left jaw, but what bothered him now was mostly that his jaw clicked when he chewed. I did the same treatment as in the third session, focusing on the lateral pterygoid because it can cause clicking by pulling the disc in the joint forward, and adding the styloid and mastoid attachments again to lessen the crowding.

We talked about perpetuating factors this time. He was stressed, being in the middle of finishing up a 6-year building project on his fabulous new home and preparing to move in. He was a detail person, and very particular, so the final details had him anxious. Who wouldn’t be after all those years and a big change coming. My jaw would be clenched too! I didn’t have to ask him to consider taking the Mindfulness Based Stress Reduction course we offer (MBSR). He suggested it himself.

Rodney has not asked for more Neuromuscular Therapy. The  pain he had experienced when chewing is no longer disrupting his gourmet lifestyle!

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