The role of temporomandibular joint mobilization in the management of benign paroxysmal positional vertigo: randomized controlled trial.

Benign paroxysmal positional vertigo (BPPV) is a common inner-ear condition causing brief bouts of spinning dizziness with head movement. It's usually treated with canalith repositioning maneuvers, which reposition displaced inner-ear crystals. This trial asked whether adding jaw joint (temporomandibular joint, TMJ) and soft tissue mobilization to standard treatment might further help, since jaw dysfunction has been linked to dizziness and balance problems.

Forty-one adults with BPPV (mean age 53.9) were randomized to receive either weekly TMJ and soft tissue mobilization for four weeks plus standard repositioning maneuvers, or standard treatment alone. Both groups showed statistically significant improvement in dizziness-related disability, but there was no significant difference between groups on this main measure. The intervention group did show significantly greater improvement in jaw function and in balance during tandem standing with eyes open. The small sample size and short follow-up limit how confidently these balance and jaw findings can be generalized, and the lack of benefit for the primary dizziness outcome is an important null result.

If you've experienced BPPV, the sudden spinning dizziness triggered by moving your head, you know how disruptive it can be. The standard treatment is a repositioning maneuver that shifts tiny crystals back into place in the inner ear.

This study looked at whether adding gentle mobilization of the jaw joint and surrounding soft tissue to that standard treatment could offer extra benefit, since jaw problems have sometimes been connected to dizziness and unsteadiness. Researchers followed 41 adults, split into two groups: one received jaw mobilization plus the usual repositioning treatment, the other received the usual treatment alone. Both groups felt significantly less dizziness-related disability by the end, but neither group did notably better than the other for that main measure.

People who received the jaw mobilization did show more improvement in jaw function and in one specific balance test, standing in a heel-to-toe position with eyes open. Because the study was small and short, these balance and jaw findings need to be confirmed by larger studies before firm conclusions can be drawn about their practical importance for people with BPPV.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This parallel-group RCT (n=41 completers, intervention n=20, control n=21) examined whether four weekly sessions of TMJ and soft tissue mobilization added to canalith repositioning maneuvers improved outcomes relative to repositioning alone in adults with BPPV. The primary outcome, Dizziness Handicap Inventory score, improved significantly within both groups (p<0.001) but showed no significant between-group difference, indicating no evidence that TMJ mobilization enhanced the primary dizziness outcome beyond standard care. Secondary outcomes told a more mixed story: the intervention group demonstrated significantly greater improvement in temporomandibular function (p<0.001) and in tandem stance balance with eyes open (mean difference 3.90 s, 95% CI 1.70-6.10, p=0.001) compared with controls.

These between-group differences suggest a possible adjunctive effect on balance and jaw function specifically, though the abstract does not report effect sizes framed in terms of clinical importance, and within-group improvement in the primary outcome cannot be attributed to the added intervention given equivalent control-group gains. Limitations include the modest sample size, single-center design implied by simple randomization, short four-week intervention period, and absence of reported blinding or long-term follow-up, all of which constrain confidence in generalizing the balance and TMJ function findings.