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For physiotherapy

When neck and shoulder keep coming back

You work on the same system as we do, just from the other side. What is written here is the part you cannot reach with your hands – and the figures that show it is not small.

You know these patients

Cervical spine and shoulder girdle complaints that return after every treatment. Treatment-resistant tension-type headaches. And incidentally, often only when asked: “my jaw grinds”.

The connection

What has been measured

  1. 01Measured / described

    The measured connection

    TMD is associated with reduced pressure pain thresholds and restricted cervical mobility – moderate evidence from systematic reviews with meta-analysis. An imbalance in masticatory muscle activity is associated with cervical myofascial pain.

  2. 02Measured / described

    The anatomical pathway

    Functional convergence of the trigeminal nucleus caudalis with the dorsal horns of C1–C3. This is not an explanatory model but a finding – and the basis for jaw and neck being able to sustain each other’s problems.

  3. 03Measured / described

    What this means for the division of work

    Manual therapy and splints often have comparable effects on pain and function; the combination is frequently worthwhile. We do not take over your treatment. We take the source out of play so that your work lasts longer.

  4. 04Where the evidence ends

    Where the evidence ends

    A splint has only a limited effect on global posture: in a prospective study with 3D body scanning, forward head posture and shoulder rounding changed after three months, but thoracic kyphosis, lumbar lordosis, pelvic tilt and knee position when standing did not. So we do not promise you postural correction via the bite.

Indication

When a referral is worthwhile

First, and without exception: red flags and unclear findings belong in specialist work-up, before any functional diagnostics. The CMD perspective complements, it does not replace.

Worthwhile

  • Rapidly recurring cervical spine and shoulder complaints with jaw signs
  • Treatment-resistant tension-type headaches
  • Restricted mouth opening, TMJ sounds, bruxism
  • Persistence beyond three months despite guideline-based treatment

Not worthwhile

  • Acute complaints before medical work-up
  • With the expectation of postural correction via bite position

Your patient remains yours.

After the assessment or after regulation is complete, we always refer back to you. We only provide further treatment at your explicit written request.

Next steps

Three routes – your choice

  • 01

    I want to know more

    The full-text sources, our measurement protocols and the clinical explanatory model with its level of evidence disclosed.

    Request documents
  • 02

    I have a question about a case

    Call-back from the CMD specialist, not from reception.

    Ask a question
  • 03

    I would like to refer

    By phone, email or letter – whatever suits you. The findings report comes back to you.

    Referral

Other specialties

To the overview