How is TMJ dysfunction diagnosed?
TMJ dysfunction (Temporomandibular Joint Disorder) can be diagnosed by a physiotherapist specializing in mandibular dysfunction, dentist, and/or maxillofacial surgeon. TMD (Temporomandibular Dysfunction) is a clinical diagnosis of movement dysfunction. Complementary diagnostic tests such as X-rays (RX), computed tomography (CT), or magnetic resonance imaging (MRI) may be recommended for a more complete diagnosis.
After the evaluation, the physiotherapist will begin treatment, if appropriate. It is an intervention that is typically very successful in treating TMJ disorders, largely because it is a movement disorder affected by muscular and/or joint motor control.
Field (2012) found that with conservative physiotherapy treatment for TMJ, 75% of patients with TMD resolved their condition within 3 months, which is consistent with our clinical results. The vast majority improve within a few weeks after starting TMJ treatment, compared to slower resolution when not intervened by physiotherapy, as studied by Rammelsberg in 2003, who found that spontaneous resolution occurs in 33% of TMD sufferers over a 5-year period.
We present the case of a female patient, 35 years old, with a history of right TMJ surgery in 2014. She presented with intense pain in the left TMJ during opening, with a limitation of 30 mm. She felt fearful during this movement, with limitations in eating, headaches in the frontal and occipital regions, tinnitus, as well as photophobia and hyperacusis (excessive sensitivity to certain sounds). She had pain on palpation in the temporal and facial regions, bilaterally, as well as the sub-occipital region, reporting that this was “the origin of her headaches.”
She started physiotherapy treatment and, after 3 weeks of progress, she was already able to open her mouth 40 mm without any pain, along with a greater willingness to perform a movement that had previously caused her fear. She was free of headaches, tinnitus, and sensitivity to sound and light.
It is another case heading towards success, the result of a multidisciplinary team, focused and guided by the patient!
Written by Sérgio Neto
