TMJ disc Displacement and Entrapment syndromes

TMJ disc Displacement and Entrapment syndromes

According to my Injury classification system, TMJ disc disorder is considered a Level 4, as per the four structures compromised in the injury, the alignment, muscle, ligamentous and cartilage/disc layers.

The predisposing factors for the development of this condition began with a misalignment dysfunction at the TMJ complex, which overtime causes  the  soft tissue ligamentous and muscle support to become overloaded and compromised allowing the biomechanical stress to reach the level of the disc and initiating the degenerative joint disease and disc misplacement.

TMJ disc syndromes Injuries causes pain and inflammation at the level of the jaw joint line, and significant restriction (locking) on either month opening and closure. Usually there is a crepitus sound associated with this condition as per the poor position of the intra articular disc.

Is important to note that for the disc to become injured, the previous defence mechanisms have to have failed to allow the biomechanical stress to damage the cartilage, therefore, the treatment care must aim to restore the health of the entire TMJ protective structures.


Assessment Protocol

The  upper extremity and spinal  biomechanical chain must be evaluated as part of the TMJ analyses as per the neurological and mechanical influences of the spine and shoulder.

Clinical assessment to identify the TMJ misalignments that have contributed to this condition. Soft tissue analysis to pinpoint the level of irritation in the soft tissue support.

 X-ray analysis

Anterior – Posterior (AP) and TMJ  view is essential to analyse the level and direction of the different patterns of misalignments and the degree of the degenerative disease.


TMJ MRI is essential for visualizing the extent of injury on the muscle/tendon and ligamentous and disc layers

Locate the exact injury point; Allows the treatment to be more specific during the application of the treatment modalities

Identify the extent of tissue damage and the presence of scar tissue; Provides valuable information regarding prognosis and the application of friction soft tissue modalities to aid on scar tissue removal.

Rule out fractures not picked up by the x-ray and rule out Flap torn disc tear.  


Treatment protocol

The treatment care should aim to restore the Knee alignment, the soft tissue muscles/tendon and ligamentous health as well as stimulating and remodelling the cartilage and disc repair and replacement.

Specific adjustments on the TMJ complex followed by a rehabilitation regime to strengthen the entire soft tissue support of the jaw.

Soft tissue and meniscus healing protocol

Application of Low-level Laser and PEMF directly over the injured tissues to aid on the cellular level of healing as well as improving the microcirculation for the area. Due to the natural poor blood supply properties of the disc, this treatment modality is essential to enhance meniscus healing

Friction soft tissue therapy helps to reduce dysfunctional scar tissue

Specific stretches and strengthening to improve the resilient of the soft tissue support

Specific selected essential oil application to enhance healing

Dry Needling to promotes blood flow and enhance the soft tissue and disc  healing.

Depending on the level injury and chronicity, a minimum of 6 weeks up to 12 weeks of treatment care may be necessary to resolve this condition.

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