Chiropractic Care for TMJ Disorder and Other Common Conditions
In the study entitled Manipulative and Multimodal Therapy for Upper Extremity and Temporomandibular Disorders: A Systematic Review that was published in the Journal of Manipulative and Physiological Therapeutics, a systematic review was conducted to determine the efficacy of manual manipulative therapy (MMT) on common upper extremity conditions and TMJ disorders. The review included randomized trials, clinical trials and case studies. After reviewing all the eligible studies, fair evidence was found to support the benefits of manual manipulative therapy for common conditions including lateral epicondylitis, TMJ disorder, and wrist and hand pain.
This study is directly relates to our practice because it demonstrates the effectiveness of manual manipulation, which is used on a majority of the patients we see. While people are familiar with the typical Chiropractic adjustment for the neck and back, the same principles can be applied to any joint in the body. Other common areas that a Chiropractor will manually adjust include the elbow, shoulder, ankle and wrist. The goal is to increase the range of motion in the joint itself, allowing it to properly move through its capable range of motion. This helps to decrease the pain in the area and reduce the stress on the surrounding muscles, effectively reducing muscle spasm and pain. Other treatment modalities can be applied to further aid in the healing process as well. These therapies can include electrical stimulation, cold-laser therapy, stretching and exercises.
Journal of Manipulative and Physiological Therapeutics
Volume 36, Issue 3 , Pages 143-201, March 2013
Manipulative and Multimodal Therapy for Upper Extremity and Temporomandibular Disorders: A Systematic Review
James W. Brantingham, DC, PhD, Tammy Kay Cassa, DC, Debra Bonnefin, DC,
The purpose of this study was to complete a systematic review of manual and manipulative therapy (MMT) for common upper extremity pain and disorders including the temporomandibular joint (TMJ).
A literature search was conducted using the Cumulative Index of Nursing Allied Health Literature, PubMed, Manual, Alternative, and Natural Therapy Index System (MANTIS), Physiotherapy Evidence Database (PEDro), Index to Chiropractic Literature, Google Scholar, and hand search inclusive of literature from January 1983 to March 5, 2012. Search limits included the English language and human studies along with MeSH terms such as manipulation, chiropractic, osteopathic, orthopedic, and physical therapies. Inclusion criteria required an extremity peripheral diagnosis (for upper extremity problems including the elbow, wrist, hand, finger and the (upper quadrant) temporomandibular joint) and MMT with or without multimodal therapy. Studies were assessed using the PEDro scale in conjunction with modified guidelines and systems. After synthesis and considered judgment scoring was complete, evidence grades of “A, B, C and I” were applied.
Out of 764 citations reviewed, 129 studies were deemed possibly to probably useful and/or relevant to develop expert consensus. Out of 81 randomized controlled or clinical trials, 35 were included. Five controlled or clinical trials were located and 4 were included. Fifty case series, reports and/or single-group pre-test post-test prospective case series were located with 32 included. There is Fair (B) level of evidence for MMT to specific joints and the full kinetic chain combined generally with exercise and/or multimodal therapy for lateral epicondylopathy, carpal tunnel syndrome, and temporomandibular joint disorders, in the short term.
The information from this study will help guide practitioners in the use of MMT, soft tissue technique, exercise, and/or multimodal therapy for the treatment of a variety of upper extremity complaints in the context of the hierarchy of published and available evidence.