Jaw Pain Assessed

Was your Jaw Pain Properly Assessed?

Traditionally, all pain and restriction in the jaw region, whether it be a clicking jaw, a painful bite, clenching, headaches or even a locked jaw, have all been diagnosed under the one umbrella term, “TMJ”  

The TMJ acronym actually stands for Temporo-Mandibular Joint, the anatomical name of the joint, so to diagnose “TMJ” is similar to you going to the GP after tripping and falling and hurting your lower leg and your GP assessing you and diagnosing you with “Ankle.” It’s merely naming the structure you injured, so a more correct umbrella term should be “Temporo-Mandibular Dysfunction (TMD)”

Incorporated in this umbrella term, there are 4 major muscles groups, 3 different ligaments, 2 joint surfaces, and an articular disc that can all be the cause of TMD, not to mention the trigeminal nerve. Management of an arthritic joint surface is vastly different from managing a spasming muscle, though their initial presentation can be very similar, meaning the ability to accurately diagnose which of these structures are actually causing the dysfunction/pain, determines the correct course of treatment to resolve the symptoms.  There is no “one size fits all” treatment approach to TMJ management

More importantly, accurate diagnosis will provide clinical evidence as to why and how the structure(s) have become involved, so treatment can be tailored to include medium and long term goals to ensure your problem doesn’t return as soon as you finish treatment.  

Consider the advice you may have already been given about your “TMD.”  

  • What was the actual diagnosis? 
  • Did you practitioner diagnose you from your description alone without actually assessing you manually?
  • What assessment techniques (if any) were used to derive that diagnosis? 
  • What were your treatment goals set after assessment?  
  • How were these goals reassessed?
  • What was the clinical reasoning behind the treatment that you may already have gone through?  
  • Did it work?

Most failed treatment occurs because of inappropriate treatment choices due to inaccurate or lazy diagnosis. Just because treatment has failed in the past doesn’t mean you are unfixable, it means you need a better assessment and an appropriate treatment plan.  There is no guesswork in treating “TMD”

 

Author: Nigel Smith