Temporomandibular Joints

The nasal sinuses are a common site of congestion, infection and inflammation and osteopathic intervention using vibration and frictional techniques can play a part in treatment in some cases. Rarely will these be a complete answer, and other methods from hot or cold packs through to antibiotics are all appropriate in certain cases. The osteopathic input can, however, add a dimension to treatment which may not have been considered by other practitioners. Some apparently simple manoeuvres can have a very profound effect on drainage, and produce benefit out of all proportion to the time and effort used. Some of these techniques can also be taught to the patient for their own use if appropriate.

Special precautions are mostly those relating to the possibility of spreading infection when the 'mask' area of the face is being worked. The lack of valves in the veins draining the face, and the chance of infection backtracking into the skull and brain must always be borne in mind.

The temporo-mandibular joints are a site of symptoms and dysfunction in some patients, and can be somewhat improved in their function by osteopathic intervention. Hyper-mobility is clearly not going to respond well to mobilizing techniques; however, when that hypermobility is due to over-stress produced by the opposite side being too tight, suitable mobilization of the restricted side can be useful. The dental surgeon has a role in assessing the occlusion of the teeth and making any suitable adjustments here, but gentle stretching of over-tight muscles and capsule can be valuable.

There are few special precautions here except to consider the indications as much as the contra-indications, and to be aware that poor results in treatment are often due to the wrong choice of treatment as much as the wrong choice of technique.

190 Techniques for the sinuses and temporo-i

190 Techniques for the sinuses and temporo-i

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