Effect of Manual Therapy and Therapeutic Exercise Applied to the Cervical Region on Pain and Pressure Pain Sensitivity in Patients with Temporomandibular Disorders: A Systematic Review and Meta-analysis.

Researchers pulled together evidence from randomized trials to see whether manual therapy applied to the neck could help people with temporomandibular disorders, or TMD, which affects the jaw joint and muscles. They found that when therapists used hands-on treatment focused on the cervical spine (the neck), patients reported less pain and showed increased pain thresholds in the muscles that control chewing. The effect was large enough to matter clinically.

When therapists combined neck treatment with direct work on the jaw and face, the results were somewhat better still, though the evidence for this combined approach was less robust. The findings suggest that the neck plays a meaningful role in how TMD pain develops or persists, and that treating it can shift both how much pain people feel and how sensitive their muscles are to pressure.

This review looked at studies where people with jaw pain were treated with hands-on therapy focused on the neck. People who received this type of treatment reported that their pain decreased, and when researchers tested how sensitive the chewing muscles were to pressure, they found improvement there too.

Interestingly, patients were also able to open their mouth wider without pain after treatment. When therapists combined neck treatment with direct work on the jaw and surrounding area, the improvements happened a bit faster, though researchers are still gathering evidence on exactly how much difference this makes.

It is reassuring that treating the neck appears to have a real effect on jaw pain, but each person's situation is different, so outcomes will vary.

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

This meta-analysis adds weight to the clinical observation that cervical dysfunction or restriction often accompanies TMD. Three studies showed consistent, large effects for neck-focused manual therapy on both pain intensity and masseter pressure pain thresholds, with a moderate effect on temporalis PPT.

The finding that cervico-craniomandibular interventions appeared somewhat more effective than cervical-only treatment in the short term is intriguing, though the evidence base here remains modest. The authors graded cervical MT as moderate evidence against placebo or minimal intervention, which is a reasonable assessment given the data available.

This work suggests the cervical component deserves integration into TMD management pathways, but also highlights that the mechanistic understanding and longer-term durability of these effects still need further investigation.