Abstract:
Temporomandibular disorders (TMDs) are the second most common form of orofacial pain after an odontogenic source. Despite their complex aetiopathology they are considered a musculoskeletal disorder. They can have a significant impact on the quality of life of those suffering from TMDs, but can be treated and managed through a mixture of conservative and surgical approaches. Physiotherapists specialising in musculoskeletal therapy and pain management can offer a variety of techniques to help in the treatment and management of TMDs. In this narrative review the evolution of physiotherapy practice in the United Kingdom will be outlined, along with a discussion about physiotherapeutic theoretical frameworks in the management of musculoskeletal disorders and idiopathic TMDs. Finally, a narrative review will be presented, outlining the literature exploring the use of physiotherapy post TMJ surgery, underpinned by a systematic literature search on the topic. After screening for inclusion in the narrative review, eight articles were included for narrative synthesis. The main findings were that there is a relative paucity of studies looking at the value of physiotherapy post TMJ surgery compared with the treatment of idiopathic TMDs, and there is heterogeneity in the physiotherapy programmes described in the literature, but the addition of physiotherapy post TMJ surgery seems to augment the patient\'s response to surgery. The article concludes by describing the domestic challenges and opportunities of integrating physiotherapy into TMD management pathways.
摘要:
颞下颌关节紊乱病(TMD)是仅次于牙源性来源的第二大常见形式的口面部疼痛。尽管其病因复杂,但仍被认为是肌肉骨骼疾病。它们会对患有TMD的人的生活质量产生重大影响,但可以通过保守和手术的混合方法进行治疗和管理。专门从事肌肉骨骼治疗和疼痛管理的物理治疗师可以提供各种技术来帮助TMD的治疗和管理。在这篇叙述性综述中,将概述英国物理治疗实践的演变,以及关于肌肉骨骼疾病和特发性TMD管理中的物理治疗理论框架的讨论。最后,将进行叙述性审查,概述了探索TMJ手术后物理疗法使用的文献,以对该主题进行系统的文献检索为基础。在筛选纳入叙事审查后,纳入了八篇文章进行叙事综合。主要发现是,与特发性TMD的治疗相比,TMJ手术后物理疗法的价值研究相对较少,文献中描述的物理治疗方案存在异质性,但是TMJ手术后物理治疗的增加似乎增强了患者对手术的反应。文章最后介绍了国内将理疗纳入TMD管理路径的挑战和机遇。