information for patients
For Patients
What is the connection between the neck-head-face and jaw?
There is a close relationship between our neck, head, face, and jaw. A common example of this relationship is the fact that a few days of neck pain are likely to cause a headache, or a few days of headache are likely to be followed by neck pain. The main cause for this is a unique pain processing mechanism of which both the face and the upper neck regions send pain signals to the brain via the same pathways, so it is as if the brain cannot differentiate at times as to which region is responsible for that pain presentation, and the end result is pain in both regions.
In addition, the upper neck and face structures have a functional and mechanical connection. For example, you might have noticed that while yawning you might have extended you r neck backwards automatically. This in fact, is a kind of a supportive movement to enable the jaw to move further downwards and by that to open your mouth freely.
These examples above may explain why many patients who present with neck pain also complain of headaches, facial and jaw pain, and vice versa, all of which are well supported by the most up to date evidence.
This is why, us clinicians should address the neck-head-jaw region as a one clinical unit: The Cervical-Cranio-Mandibular (CCM) complex.
What are the common CCM complex problems treated by Physiotherapists?
Neck pain (locally or remote to the shoulder blades & arms)
Headaches with neck involvement (as identified in clinical assessment)
Temporomandibular Joint Disorders (TMJ) (Jaw pain originating from masticatory muscles, joint pain, click and locks)
Orofacial pain (non-muscular facial pain)
Dizziness with neck involvement (as identified in clinical assessment)
What does physiotherapy treatment entail?
Personal patient-therapist connection: I strongly believe that a close and personal patient-therapist connection is vital for a successful rehabilitation process. This connection helps in promoting existing and new healthy behavior patterns by encouraging and empowering the patient’s sense of self worthiness and ability.
Manual Therapy: Human touch is a great tool for establishing a healthy connection between people. Hands on manual therapeutic techniques that mobilize and release joints, soft tissue and other tissues, play a major role in my treatment sessions, as they promote various physiological aspects in the healing process such as in the brain and nervous system.
Dry needling: Dry needling is a western approach of needling for musculoskeletal pain disorders. The effectiveness of dry needling for various myofascial pain syndromes is well supported by research, as well as for CCM related pain presentations. Dry needling is not a stand-alone treatment and is a great adjunct tool to manual therapy.
Taping: Taping is another adjunct tool for supporting the musculoskeletal system and assisting the body in the natural healing and different recovery stages. …… A support of the either rigid or elastic (Kinesiotape) application may assist the patient’s awareness as to movements that may be dangerous or even limit that movement in order to protect the region injured.
Therapeutic Exercise and education: Movement is the key to life and eventually there is no substitute for physical activity. Manual therapy, dry needling and taping are passive tools cannot train your muscles unfortunately, as they only provide a temporary answer to your pain and dysfunction. The body-mind-soul modifications that occur after an injury or within painful presentations can best be restored by an addition of individually tailored physical activity program (therapeutic exercise). Physical activity has been proposed and clinically proven as the optimal ‘medicine’ for many musculoskeletal and other health related conditions.
Is the physiotherapy treatment you offer based on science?
I am clinician, lecturer and researcher – in that order. Scientific research is an important part of the triangle that includes the patient (your world and narrative), the therapist (and his expertise) and science (evidence based/ informed practice). In my opinion, the ideal clinical practice relies on the science but remains flexible enough and modifies it all based on the patient in hand and according to the circumstances.
How long will it take until I feel an improvement?
Of course, it is very individual but most patients with Cervical-Cranio-Mandibular problem (that are orthopedically related/ musculoskeletal) tend to improve well withing 4-6 weekly visits (usually of 30-50 min). Important to note is that a positive response to treatment is vital for confirming that the problem is indeed of a musculoskeletal origin. If you do not improve within that timeframe you are likely to be referred for further medical investigations.
Having said that, a chronic CCM pain condition (> 12 months), as with other chronic problems, may take longer to improve and prognosis is based on the each individual case.