TMD & Orofacial Pain – Advanced Skills

The main role of the neck is to carry the head in order to serve its main functions such as sight, hearing, mastication (including taste) and correct its position in space according to the various demands and surrounding (proprioception). This major role connects the neck-head-face and jaw into one major functional complex in which its components are inter-related and affect each other. Additionally, the modern neuroanatomy research demonstrates that there is a strong neural sensory connection between the various parts of this complex, such that noxious stimuli in a specific region (such as the right side of the upper neck) can easily lead to pain presentation in another region (around the right eye in this example) and vice versa.

In my PhD research project that was done at Tel Aviv University we characterized upper cervical spine musculoskeletal pain and related performance parameters, as well as assess the prevalence/incidence of cervicogenic headache among patients with Temporomandibular Disorders (TMD). The trend we observed was clear and demonstrated significant specific upper neck impairments in patients with painful TMD, where over a third of them were diagnosed with Cervicogenic Headache versus 5% in the general population.

These findings, also supported elsewhere in the literature, have led to the understanding that the ideal management of this population, for us physiotherapists, requires understanding of the whole Cervical-Cranio-Mandibular complex.

To date, more than 25% of the adult population report significant pain somewhere in the Cervico-Cranio-Mandibular (CCM) complex, which is of a musculoskeletal nature, which commonly becomes chronic, second in its prevalence to Chronic Low Back Pain (LBP). Hence, rehabilitation of the CCM complex in this population is highly relevant for physiotherapists, osteopath and chiropractors especially as unfortunately, these patients are hardly referred to manual treatments. Whatever the reason may be for this unfortunate approach, now is the time to introduce change and demonstrate the effectiveness of manual treatment management in the field of Cervico-Cranio-Mandibular complex pain.  Certification and expertise in the management of CCM pain will help you widen your scope of practice and help more patients, who many times suffer from mismanagement.

There is vast evidence also of strong quality (such as systematic reviews and meta-analyses) to demonstrate the effectiveness of manual treatments and exercises as first line treatment for people with CCM disorders (neck pain, cervicogenic headache, TMD). This is similar to the role of manual traetments management of non-musculoskeletal headache/orofacial pain (e.g., migraine or Tension Type Headache (TTH)) which is recognized complementary clinical practice as part of a multidisciplinary team (including for example neurologist, psychologist, physicians etc.).

Cervical-Cranio-Mandibular therapeutics
A 48 hours comprehensive course, consisting of three independents modules, that can also be taken individually. No previous experience needed.
Module 1: Cranio-Mandibular therapeutics(16 hours)
Module 2: Cervico-Brachial therapeutics(16 hours)
Module 3: Cranio-Cervical therapeutics(16 hours)
Dry Needling for Orofacial Pain & Headache (9 hours)
In this one-day workshop participants will learn and practice safe and effective dry needling approaches for the most commonly involved myofascial structures in patients with orofacial pain (mainly TMD) and headaches (cervicogenic, tension type and migraine).