Dear physio
Would you teach me the treatment of patient with neck pain and temporomandibular
join dysfunction?
1.Patient profile
25 years old female.She has been suffered from TMJ dysfunction for 10 years
and been treated by a dentist.She has never undergone a surgery.
2.Diagnosis and treatment by a dentist
From patient's information diagnosis is bi-lateral TMJ dysfunction with fused
joint,rather severer in right side.
She has been wearing mouth piece,orthotic device at night.
3.Present history
When she got up in the morning 1 month ago,she had a neck pain.
So she consulted an orthopedist and was diagnosed that the pain was not
originated from cervical spine.She was prescribed a stupe and anti-inframmentary
medicine.After 1 month the symptom was alleviated.
But yesterday she had a neck pain and eyeache when she raised her upper
extremities and could not sleep over night.
She had just changed mouthpiece.
4.Examination
(1)ROM test
right left
cervical flexion 30
extension 30
rotation 40 55
side bending 20 20
(2)The distance between the upper and lower teeth is 2.5 cm(1 inch).
(3)Pain
Of cource there is a movement pain especially in right rotation.
When I investigate the tender point in her neck,the tender point moved.
This may be owing to my poor examination skill.
Could someone teach me refference books or how to treat this patients?
Myofacial pain dysfunction syndrome is considered for one of causes of this
symptom.But I don't know how to treat this syndrome.
It seems that mobilization of TMJ is not the indication in a fused TMJ.
I cannot find Japanese standard protcol,which is said not to be inferior to
grobal standard,in Japanese books.
I was never educated about it in Japanese PT schhol.
Maybe it might be educated when I was sleeping in lecture.
I made her next visit postpone from 28 Sep.to 2 Oct. because I must study
how to treat her.
Please help me and my patient.
Best regards
Hiro Wood
Japan
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