Migraines and headaches may co-occur with neck or jaw pain or all by themselves. Physical Therapists are specialized clinicians that have the necessary training to determine the source of the problem and if the patient needs to be referred to another specialist, such as a physician if the source of the problem is out of the scope of the practice or to the ER if it is an emergency. This technique is called Differential Diagnosing and allows Physical Therapists to have Direct Access to patients (no need to see the MD first) in several states like California. Ask us how.  Physical therapists perform thorough and exhaustive and on many occasions ongoing, assessments that render very important. 

 

Since it can get complicated, let’s break it down: 

 

NECK PAIN: whether neck pain developed over time, due to work, after a car accident, or without a specific reason, neck pain can be categorized into 4 groups:

  1. Neck pain with mobility deficits 

  2. Neck pain with movement coordination impairments (including whiplash-associated disorder [WAD]) 

  3. Neck pain with headaches (cervicogenic headache) 

  4. Neck pain with radiating pain (radicular)

 

Each of the categories follows algorithms based on symptoms, history, signs, and finding from the Physical Therapy evaluation. When any of these overlaps an ongoing assessment (monitoring and contact with the PT several days during the week)  is usually necessary. When a patient presents with a problem that has lasted a significant amount of time, treatment can take longer and intensive therapy (several visits per week) is suggested and might be required. BreakingThrough utilizes light and gentle approach with a combination of manual therapy, traction, neuromuscular reeducation, and strengthening to decrease pain and increase blood blow. 


headaches, temporomandibular dysfunction or TMJ, and neck pain

TemporoMandibular Dysfunction (TMD) 

 

TMD, TMJ or jaw pain is what at least 5% of our population experience (PubMed). This is a condition dentists are questioned by their patients after they see signs of wear, chipping and damaged teeth due to grinding. They usually prescribe a mouth guard for protection of the teeth. Other treatments that are used are anti-inflammatories, cortisone shots to the joint, botox to the masseter muscle (main chewing muscle), etc. Physical Therapy offers different techniques and methods to decrease the pain in the jaw such as grade II mobilization with oscillation, masseter muscles release, trigger point release in the temporalis and masseter muscles, retrain the mandible depressors (jaw openers), and multiple modalities. The benefit of Physical Therapy is the lack of side effects such as digestive system distress or no toxins are entered into the body.

 

The previously mentioned techniques are mainly done for stiff temporomandibular joints. However, pain in the TMJ can be caused by sprains, disc displacement which causes clicks or ligament sprains which calls for stabilization of the TMJ to avoid irritation of the joint. Many modalities can be used to provide these therapies: IASTM, cryotherapy, moist hot pack, iontophoresis.

 
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Dr. Santiago Osorio