Some manual therapy for the jaw works on the neck and general region, while some is applied directly to the craniomandibular structures, meaning the jaw joint and chewing muscles themselves. This review focused specifically on that direct, hands-on jaw work and its effect on pain and jaw range of motion.
The authors gathered randomised trials of craniomandibular manual therapy in people with TMD, examining pain intensity and maximum mouth opening.
Clarifying whether working directly on the jaw structures helps guides technique choice, and this was the first review to focus specifically on that question.
Hands-on techniques applied directly to the jaw joint and chewing muscles, including intra-oral and external soft-tissue and joint work.
The review concentrated on pain intensity and maximum mouth opening, the core problems in TMD.
Direct jaw work showed promise, with the usual caveats about evidence quality.
Manual therapy applied to the craniomandibular structures was associated with reduced jaw pain.
It was also associated with improvements in maximum mouth opening.
This was the first review to focus specifically on direct craniomandibular manual therapy for TMD.
The authors call for higher-quality trials to confirm which techniques work best for whom.
Manual therapy applied directly to the jaw joint and chewing muscles was associated with reduced jaw pain and improved mouth opening in TMD, though higher-quality research is needed to refine the approach.
This supports skilled, direct hands-on work at the jaw itself, including intra-oral techniques where appropriate and within scope, as part of TMD care, alongside treatment of the neck and surrounding muscles.
It reinforces treating the whole craniomandibular and cervical region rather than one spot, and coordinating with the person’s dentist or doctor when needed.
Supports direct soft-tissue and trigger point work on the jaw and chewing muscles, within scope and training.
Backs craniomandibular manual therapy and mobilisation for jaw pain and mouth opening.
Reinforces massage of the masticatory and neck muscles as part of a TMD plan.
Complements direct jaw work with needling of masticatory trigger points where indicated.
The number and quality of trials focused specifically on direct craniomandibular manual therapy were limited, and techniques varied, so the certainty of the evidence is not high. Intra-oral techniques require appropriate training and consent, and some may sit outside certain practitioners’ scope.
TMD is multifactorial, so direct jaw work is one part of a broader plan. Please confirm the citation details against the source before publishing.
This review found manual therapy applied directly to the jaw joint and chewing muscles was associated with reduced pain and improved mouth opening in TMD, while calling for higher-quality research.
For myotherapists and physiotherapists, it supports skilled direct jaw work, within scope, alongside treatment of the neck and surrounding region.
Effectiveness of Manual Therapy Applied to Craniomandibular Structures in Temporomandibular Disorders: A Systematic Review. Asquini G, Pitance L, Michelotti A, Falla D. Journal of Oral Rehabilitation, 2022; 49(4): 442-455.
