When neck and shoulder keep coming back
You work on the same system as we do, only from the other side. What is set out 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 headaches. And in passing, often only when asked: “my jaw grinds”.
What has been measured
The measured connection
TMD goes with reduced pressure pain thresholds and restricted cervical spine mobility – moderate evidence from systematic reviews with meta-analysis. An imbalance of masticatory muscle activity is associated with cervical myofascial pain.
The anatomical pathway
Functional convergence of the trigeminal nucleus caudalis with the dorsal horns C1–C3. That is not an explanatory model but a finding – and the basis for jaw and neck being able to keep each other going.
What this means for the division of labour
Manual therapy and splints often have comparable effects on pain and function; combining them is frequently sensible. We do not take over your treatment. We take the source out of play, so that your work lasts longer.
Where the evidence ends
A splint has only a limited effect on global body posture: in a prospective study with 3D body scan, forward head posture and shoulder protraction changed after three months, but thoracic kyphosis, lumbar lordosis, pelvic tilt and knee position in standing did not. So we do not promise you a postural correction via the bite.
When a referral is useful
First and without exception: red flags and unclear findings belong in a specialist work-up, before any functional diagnostics. The CMD perspective is complementary, not a substitute.
Useful
- rapidly recurring cervical spine and shoulder complaints with jaw signs
- treatment-resistant tension headaches
- restricted mouth opening, jaw joint noises, bruxism
- persistence over three months despite guideline-based treatment
Not useful
- acute complaints before a medical work-up
- with the expectation of a postural correction via the bite position
Your patient remains yours. After the assessment, or after the regulation is complete, we always refer back to you. We take on any treatment beyond this exclusively at your express, written request.
Three routes – you choose
I want to know more
The sources in full text, our measurement protocols and the clinical explanatory model with the level of evidence disclosed.
I have a question about a case
A call back from the CMD specialist, not from reception.
I would like to refer
By phone, e-mail or letter – whichever suits you. The findings report comes back to you.