Current Pain and Headache Reports

, Volume 5, Issue 5, pp 421–431 | Cite as

Nonpharmacologic approaches to the management of myofascial temporomandibular disorders

  • Jeffrey J. Sherman
  • Dennis C. Turk


The temporomandibular disorders (TMDs) are a heterogeneous group of painful musculoskeletal conditions that include masticatory muscle pain. TMD is a common condition but its etiology is, as yet, poorly understood. Although TMD can be quite disabling, most patients presenting with symptoms improve regardless of treatment type. This article focuses on nonpharmacologic treatments for TMD; recent articles on etiology, assessment, and treatment for this muscle pain condition are reviewed.

Psychological approaches include biofeedback, minimal therapist contact interventions, relaxation, and cognitivebehavioral therapy. We suggest that treatments based on the biopsychosocial model of illness should be used concurrently with treatments focusing only on the biomedical aspects of TMD. Psychological treatments need not be viewed as a treatment of last resort, but rather should be delivered concurrent with biomedical treatments. We present data from recent clinical trials showing that treatment-matching approaches tailoring psychological and educational treatments to psychosocial profiles, delivered concurrent with usual dental care, results in greater and more sustained improvement than usual dental care alone. As such, treatment for TMD should be viewed in much the same way as treatment for most other chronic pain conditions, that is, from a multidisciplinary perspective.


Chronic Pain Condition Myofascial Pain Temporomandibular Disorder Cognitive Behavior Therapy Intervention Occlusal Splint 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Current Science Inc 2001

Authors and Affiliations

  • Jeffrey J. Sherman
    • 1
  • Dennis C. Turk
    • 2
  1. 1.Department of Oral MedicineUniversity of WashingtonSeattleUSA
  2. 2.Department of AnesthesiologyUniversity of WashingtonSeattleUSA

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