12. Lab: Head Pain, Migraine, and TMJ

Question 1

What type of treatment can you do for myofascial tension headaches?

Answer 1

Cranial Strain Patterns
Check sutures
MFR for fascia

Question 2

What two treatments can be done for hypertonic suboccipital muscles?

Answer 2

Suboccipital release

Cervical traction

Question 3

What is the difference between a tender point and a trigger point?

Answer 3

Trigger point has a predictable pain pattern, it radiates, and has a twitch response

Question 4

Describe how you would do ischemic compression for a trigger point?

Answer 4

Place thumbs over/pinch trigger point
Hold down pressure until it melts away
-will hurt pt

Question 5

Where will some trigger points be that can cause tension headaches?

Answer 5

Upper trip
Levator scapulae
Sternocleidomastoid

Question 6

How would you know if a headache was due to facet pain?

Answer 6

Palpation over the facet reproduces pain pattern

Question 7

How do you treat facet headaches?

Answer 7

Any articulatory technique

Direct (MET/ART/HVLA)
Indirect (BLT/FPR/Still)

Question 8

When would you use TMJ/BLT compression?

Answer 8

TMJ dysfunction, worse when OPENING

Question 9

Describe how to do TMJ/BLT compression

Answer 9

Thumbs on lateral rami, other digits on mandible

• gentle compression of mandible TOWARD TMJ until relaxation
• Push mandible toward ease
• hold until relaxation

Reassess

Question 10

When would you do TMJ/BLT decompression

Answer 10

TMJ dysfunction, worse when CLOSING

Question 11

Describe how to do TMJ/BLT decompression

Answer 11

Thumbs on lateral rami, other digits on mandible

• gentle compression of mandible AWAY from TMJ until relaxation
• Push mandible toward ease
• hold until relaxation

Reassess

Question 12

What muscles would you palpate for TMJ headaches?

Answer 12

Temporalis
Masseter
Medial Pterygoid

Question 13

Temporalis MFR

Answer 13

Place finger pads over the fascia
Take into direct or indirect (F/E, RR/RL, SR/SL)
Hold until release

Reassess

Question 14

How would you treat masseter counterstrain?

Answer 14

Palpate tenderpoint inferior to zygoma
Set tenderness scale
Move jaw TOWARD TP until 70% improvement +
Hold for 90s
Reassess

Question 15

How would you do medial pterygoid counterstrain

Answer 15

Palpate tenderpoint 2cm on medial aspect of jaw
Set tenderness scale
Move jaw AWAY from TP until 70% improvement +
Hold for 90s
Reassess

Question 16

Which way does the jaw deviate during TMJ?

Answer 16

Toward the deviation side

Question 17

What are the types of jaw deviation?

Answer 17

Lateral deviation (C shaped)
Jaw S Curve deviation

Question 18

Left lateral jaw deviation B/L temporalis, masseter, medial pterygoid MET

Answer 18

Place fingers on pts chin
Passively translates jaw TO THE RIGHT until restrictive barrier
Instruct pt to move jaw to neutral
Repeat 3-5x
Reassess

Question 19

S Curve Jaw deviation B/L temporalis, masseter, and medial pterygoid MET

Answer 19

Place fingers on pts chin
Passively depress jaw to restrictive barrier
Instruct pt to close jaw to neutral w slight force
Repeat 3-5x
Reassess

Question 20

S Curve Jaw deviation lateral pterygoid, digastrics, mylohyoid, and geniohyoid MET

Answer 20

Place fingers on pts chin
Passively close jaw to restrictive barrier
Instruct pt to open with slight force
Repeat 3-5x
Reassess