Temporomandibular disorders (TMD) are a constellation of different musculoskeletal disorders that involve the TMJ, muscles of mastication, cervical muscles and associated structures. Pain can be accompanied with TMJ biomechanics such as chewing, mouth opening, or talking. Sometimes TMD can be debilitating, affecting the quality of life of the patient. Differential diagnosis is critical since pain can be of arthrogenous or muscular origin or both, influencing management. Management of TMD is fundamentally conservative and may include different pharmacological and non-pharmacological treatment modalities. TMD can cause a secondary headache such as headache attributed to TMD and also be comorbid with headache disorders particularly migraine. The presence of TMD may increase the prevalence of headache, may exacerbate an existing headache disorder and potentially may support the progression to a chronic migraine state, therefore understanding of TMD and their identification in the headache patient is critical for optimal care.

Cranial neuralgias are prevalent pain disorders that are often undiagnosed, and can exacerbate co-existing headache disorders, most commonly chronic migraine. Without making an accurate diagnosis, diagnostic and therapeutic interventions such as nerve blocks are frequently not offered to the patient. When procedures are performed, a clear understanding of the anatomy including surrounding musculature, vasculature, and connective tissue is necessary to ensure that procedures are performed with optimal technique in the proper location. There will be an emphasis on the occipital nerves (greater, lesser, and third), supraorbital nerve, supratrochlear nerve, and auriculotemporal nerve. There will also be discussion on volume dependent nerve decompression via hydro-dissection as well as the indications and pitfalls of surgical decompression.

Expert Panel Discussion

Expert Panel Discussion

We will look the origin of the GON and the LON and trace it from proximal to distal. We will investigate areas where the nerves could be tethered or irritated.

This presentation will utilize cadaver dissections to highlight anatomical structures and relationships important for clinical treatments.

Cadaver Dissection Session: Station:Physical therapy for the patient with headache. This 15 min lab station will include in-person physical therapy assessment of posture and the cervical spine with discussion of relation to headache. Referred pain patterns of cervical musculature to the head will be discussed.

Anatomical insight and knowledge about understanding and treating Temporomandibular Disorders.