Education and exercise in the treatment of temporomandibular disorders
published in July - December 2022 - in Il Fisioterapista - issue n.2
Anna Manzari

Temporomandibular disorders (TMD) are nonocclusal musculoskeletal disorders involving the masticatory muscles, the temporomandibular joint (TMJ) and/or associated structures. The etiopathogenesis is multifactorial; TMD are the leading cause of orofacial pain of non-dental origin with a prevalence of 10-15% in the adult population. To date, evidence supports the use of conservative and reversible therapies for TMD treatment. Physical therapy is among the commonly used treatments for TMD, focused on education, manual therapy and exercise. Patient’s education aims to explain the diagnosis, prognosis and therapeutic strategies. These may include recognition and monitoring of para-functional behavior, which can contribute to overloading the TMJ and chewing muscles, or the temporary use of a “pain-free diet”. The goals of exercise therapy in the treatment of TMD are to decrease pain, reduce muscular hyperactivity and disability, re-establish muscle function and joint mobility and prevent the onset of persistent pain. It is important for the clinician to “profile” the patient to identify which bio-psycho-social factors contribute to the disorder in order to set up an individualized treatment plan in which, if psycho-social factors predominate, other professionals may also intervene.