Background and Purpose: Temporomandibular disorder (TMD) often leads to chronic pain and disability. Current evidence supporting potentially effective physical therapy (PT) intervention in TMD is limited, however, some support exists for manual therapy, education, and exercise. The purpose of this case series was to describe outcomes in participants with TMD treated with cervical spine manual therapy, education, and exercise. Methods: Five participants (mean symptom duration 2.2 years) with TMD were treated with atlanto-occipital and C2-3 cervical spine thrust joint manipulation (TJM), behavioral education, and a home exercise program for 3 visits over 4 weeks. Primary outcomes included jaw range of motion (ROM), Numeric Pain Rating Scale, Jaw Functional Limitation Scale, and Global Rating of Change (GROC). Secondary measures included pain pressure threshold (PPT), Neck Disability Index, TMD Disability Index, and cervical ROM. Results: Clinically meaningful change was noted in cervical and jaw ROM. Three of five participants (60%) reported symptoms at least “moderately better” (≥ 4 GROC) at 4-weeks. No adverse events were reported. Clinical Relevance: All participants had at least 1 year duration of pain indicating spontaneous recovery was unlikely. While cause and effect relationships cannot be determined, outcomes indicate the approach may be effective. Conclusion: Cervical spine TJM added to education and exercise over three visits may be effective in the chronic TMD population. Future randomized clinical trials are necessary to draw specific conclusions

Author Bio(s)

At the time this manuscript was submitted, Breanna Reynolds PT, DPT, PhD, FAAOMPT was an Assistant Professor in the department of Physical Therapy and Health Science at Bradley University in Peoria, IL. She maintains clinical practice hours with Rock Valley Physical Therapy. She is now an Associate Professor at South University

Jamie Brown PT, DPT is a physical therapist with OSF Rehabilitation, Fort Jesse in Bloomington, IL.


The authors would like to thank Bradley University for supporting student and faculty research, Grace Gilfillan SPT for assisting in data collection. There is no funding support to acknowledge.


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