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Using Primitive Motor Reflex Testing to test if TMD is primary reason that is undermining your posture and contributing to Chronic Pain

March 06th, 2013

Many chronic pain sysndromes patients manage their pain with analgesics, and anti-depressants.  Years ago I learnt a new algorithm for treating chronic pain which has dramatically changed the way I assess and treat TMD. This technique was presented by Dr John  Beck, a medical doctor with a masters degree in Neurobiology. In 2004 he worked along side physiotherapists trained in Neuromuscular rehabilitation techniques. He developed the P.A N.E process (Practical Application of Neuropostural Evaluation)

(The next part is from Dr Beck’s article on P.A.N.E Process -Practical application of Neuropostural evaluation. September 2008 Volume 8 issue 7 of Practical pain management journal)

Allopathic medecine has traditionally relied on an  algorithm based on subjective complaint -a pathoanatomic search to solve medical and physical problems.

Dr Beck challenged the time honoured chestnut, atleast in matters concerning chronic pain. It is true that in acute pain the pathology is usually where the pain is. In chronic pain the brain and body have instituted a variety of compensatory mechanisms that may dramatically alter the degree and location of symptoms, rendering them useless in identifying the true cause of problem. Over the years with a poor record of treating chronic pain, he felt a new algorithm was in order

It would be useful at this point for the reader to review the mechanics of neuropostural motor testing  ( July/August Volume 8 issue 6 and September 2008 , volume 8 issue 7 of practical pain management journal)

Dr John Beck’s 8 simple motor reflex tests is based on the foregoing-each with an association to certain causative pathologies.

Prior to knowing about these tests, I often wondered if  one injury could undermine posture long enough to  lead to a compensatory injury/injuries? I believe this is true in many cases.

Consequently, every patient who comes in with facial, ear, neck and shoulder pain, I use 2 motor reflex tests, (These are not strength tests) to see if TMJ/TMD is primary source of their chronic pain syndromes.

Dr Beck’s description: These 2 tests will reveal the existence of temporal mandibular joint disorders (TMJ/TMD) and lateral cervical and supraclavicular allodynias.

If TMD primary, I suggest they wear the Aqualizer splint temporarily up to 8 hours a day. Clinically this can improve pain in compensatory sites or  headaches which they often report they have had for years.

Reducing of inflammed joints is critical as you can imagine. Therefore did you know that clenching and grinding as well as causing a repetitive injury, contributes to an adaptive/compensatory forward head posture that results in neck and lumbar pain. This has been well researched

Dr Steve Olmos, a leading authority on TMD, published a paper on this and demonstrated that decompression of the joints using the  Aqualizer or an oral appliances  results in a return of head posture of 4.43 inches on average.

If the reason for postural instability is the jaw joints, then  those patients will only have stabilization of their balance when the jaw joints are decompressed. He says”these tests are critical in my opinion”

CR_Posture

As well as wearing the splint the patient must  work on Rocabado 6×6 exercise protocol which I have mentioned in earlier blog

Why do TM Joints continually stay inflamed?

In addition, to poor posture, if you consider that we swallow twice every minute. During every swallow our teeth touch causing additional injury to these already inflamed joints. It is the only time during a day that it is normal for teeth to touch. (Teeth do not touch during mastication or speech).  Teeth touching produces the closest distance between the condyles of the TMJs and temporal fossa of the cranium which can cause inflammation if bite is “off”

These motor reflex tests are therefore very important in treating  multiple areas of pain.to find out if TM Joints are primary origin of pain.

Motor Reflex is one of the reasons why Dr Steve Olmos has set up 15 TMD and Sleep disorded breathing Centres (www.TMJTherapyCentre.com) throughout North America and New Zealand to deal with chronic pain. This helps find the structural origin of pain.

I believe that I would not be as successful in treating chronic pain syndromes without screening using these primitive motor reflexes

 

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