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The role of physiotherapy in the management of TMD

4 April 2014

The role of physiotherapy in the management of TMD

Anne Budenberg discusses using physiotherapy for patients with Temporomandibular disorders

The Association of Chartered Physiotherapists in Temporomandibular Disorders (ACPTMD) is a clinical interest group, established in November 2009,dedicated to the advancement of physiotherapy for patients with Temporomandibular disorders (TMDs). Physiotherapy clinicians in the North West of England and the TMD Clinic, Manchester Dental Hospital, started the group as a response to the lack of specialist physiotherapy practice for this patient group. Now the ACPTMD has over 140 physiotherapists listed on their website, and a committee made up of clinicians and academics across the UK.

A primary objective of the association is to promote the highest standards of clinical physiotherapy practice in the treatment of TMDs. Traditionally, there has been a paucity of clinical attention from physiotherapists towards patients with jaw and facial pain.  It is unclear why this is, especially as there is good evidence to support the use of physiotherapy in the management of TMDs. Other manual therapy groups, such as Osteopathy and Chiropractic regularly manage patients with maxillofacial pain and jaw movement problems, but physiotherapy has so far failed to meaningfully engage with this patient group. It appears that there are only small regional groups of clinicians who happen to have a specific interest in TMDs who offer physiotherapy services. This has resulted in gross national inequality for this patient group, and confusion for referring parties, i.e. doctors, dentists, and maxilla-facial medical and surgical specialists. The ACPTMD aims to provide a balanced, evidence-based standard of care throughout the UK.

The group hopes to provide a forum for promoting the exchange of ideas and new developments in treatment of these conditions. Although evidence supports physiotherapy as an intervention at a fundamental level, there is still a lack of clarity as to precisely which physiotherapy interventions are most effective. Not being a priority area for the majority of clinicians, creative and innovative thought and practice seems to be limited. The group provides an excellent forum for exchange of ideas regarding good practice, challenging existing practice, and providing peer support for the development of new practice methods.

In line with this, ACPTMD is working hard to provide and promote educational courses, which cover current clinical practice.

ACPTMD is currently working with the Chartered Society of Physiotherapy to establish an identity as a recognised Professional Network. This relates to the groups aim of maintaining and strengthening relationships between itself and other organisations. The group hopes to develop future working relationships with relevant medical and dental organisations. The group has dental representation at committee level and hopes to develop existing links with regional and national medical groups. The group thoroughly embraces the multi-disciplinary nature of TMDs management.

Ultimately, it is the purpose of the ACPTMD to promote professional and public awareness of the benefits of physiotherapy in the treatment of TMDs. ACPTMD intend to work hard over the next few years to raise the profile of TMDs management and provide the right information to the public and media about the value of physiotherapy management in the care of patients with TMDs.

In addition to UK activity, the group has established strong links with physiotherapy TMDs groups in Holland.  The Dutch groups are well established and have had a role over the last two decades in facilitating care pathways in Holland to be inclusive of valuable, evidence-based physiotherapy.

ACPTMD website:

Anyone wishing to contact the ACPTMD for further information, or to become involved with the group, please contact the group’s Secretary:

Information for dentists please contact the Dental Liason Officer, Anne Budenberg

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