Physical therapist guided active intervention of chronic temporomandibular disorder presenting as ear pain: A case report

ABSTRACT

This case report describes the successful physical therapy management of a 40-year-old female who presented with left ear pain referred from the temporomandibular joint. Diagnosis was primarily based on clinical examination findings and ruling out of red flags. Guidance was given on active self-care approaches consisting of pain neuroscience education designed with individualized pain curriculum, exercise therapy, manual therapy, and breathing exercises for a period of  sixweeks. Clinically meaningful improvements were obtained in the outcome measures of Numeric Pain Rating Scale (NPRS), Patient-Specific Functional Scale (PSFS), and Global Rating of Change (GROC) scale and progress in Pain-Self Efficacy Questionnaire (PSEQ) and Tampa Scale for Kinesiophobia (TSK) scores. Positive changes were achieved with functional activities (chewing, eating, yawing, brushing teeth and physical intimacy), and the patient was pain-free on discharge, which was maintained at a six-month follow-up.

KEYWORDS:

• Temporomandibular joint
• temporomandibular disorders
• orofacial pain
• craniomandibular
• craniofacial
• physical therapy
• manual therapy
• exercise therapy
• pain neuroscience education
• chronic pain
• active treatments
• passive treatments

Declaration of interest

The authors declare no conflict of interest in relation to the present study.