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Recurrent orofacial pain with concomitant diffuse pain and sleep bruxism

Clinical Cases in Sleep Physical Therapy, Page: 123-133
2023
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Book Chapter Description

The present case report is summarizing management in physiotherapy (PT) of a now 31-year-old female with recurrent comorbid orofacial pain and sleep bruxism (SB). For a period of 3 years, the person was followed in PT for random occurrence of intermittent orofacial pain located at the bilateral temporomandibular joint (TMJ) area. At evaluation, we noticed the main complaint was associated with pain elsewhere in the body, a history of SB, and a temporomandibular disorder (TMD) pain which was mainly exacerbated by stressful periods. After comprehensive management, use of dental orthoses (night guard) and physical therapy interventions targeting (1) SB complaints, (2) pain in other body sites (such as head, neck, TMJ and shoulders), and (3) stress, a clear relief was reported. These included PT-guided exercises, stress and pain management, manual therapy, and myofascial release. To achieve an acceptable well-being and therapeutic success with such complex cases, PT needs to assess the role of comorbidities and collaborate with other health professionals such as dentists, psychologists, and sleep specialists when anxiety, and stress or sleep disorders (e.g., bruxism, apnea, insomnia) are suspected. Considering main patient complaints with a larger perspective of comorbidities contribute as well as interdisciplinary collaboration may contribute to treatment success and prevention of recurrences.

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