Modern physiotherapy for temporomandibular joint disorders

  Temporomandibular joint disorder (TMD) is a general term for a group of disorders that involve the temporomandibular joint and/or the masticatory muscle system. The main manifestations are maxillofacial pain, restricted mouth opening and joint popping. The causes of this disease are complex, and its treatment often requires multidisciplinary collaboration. No single treatment can be all-inclusive and solve all TMD problems, while physical therapy (including physical factors, manipulation, and exercise) is an indispensable basic treatment both for non-surgical treatment and after surgical treatment.  Today, rehabilitation medicine has come a long way. Modern physical therapy has evolved from the single instrument-based approach of traditional physical therapy to a multi-instrument approach. Traditional physiotherapy is only physical factor therapy. Modern physical therapy can be summarized by “3M”.  1.Modality, physical factor therapy: mainly rely on instruments. For TMD, the commonly used physical therapy are: wet heat, ultrasound, short wave, low frequency electrotherapy. The purpose is anti-inflammatory and analgesic.  2, Manual, manipulative therapy: for TMD, it is a variety of stretching and loosening techniques. The main function is to increase the mobility of TMJ, that is, to increase its mobility in all directions, including openness, anterior extension, and left and right lateral deviation.  3.Movement: For TMD, we try to restore the normal kinematics of TMJ by designing movements and retraining the neuromuscular control ability under professional guidance.  In addition, for TMD patients, Education is also important, as we teach the patient the correct posture, including the head and neck and the mouth (teeth, tongue).  According to foreign literature and clinical experience, physiotherapy has been shown to be about 70% effective in patients with the following types of TMD, including periarticular muscle dysfunction, TMJ capsulitis, capsular fibrosis, reversible anterior displacement of the articular disc, irreversible anterior displacement of the articular disc, and early osteoarthritis of the TMJ. Both patients with acute injuries and chronic (more than 3 months of duration) have shown varying degrees of efficacy after several treatments, especially in terms of improving the patient’s pain and mouth opening.