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Manual therapy for Facial Pain and TMD

Eating should be one of life’s pleasures. And talking should come easily without hesitation from pain. But this reality feels really far away if you are suffering from pain in your face, head, neck, or mouth.

Nerve endings in our head are very dense because of the high value mother nature has placed on eating, communicating, and sensing our environment.  Pain in our face can be more intense than other areas of our body because of these numerous nerve endings and the input from these nerves is of high importance to the autonomic nervous system.  Manual therapy can help restore balance to the structures of the head so that all of these nerves move freely and you can rest deeply.

The cranium is made up of 22 individual bones; 8 cranial bones and 14 facial bones.  All of these bones should move in relation to one another.  Besides the temporomandibular joint (TMJ), we don’t typically think of having joints in our head.  But the joints between these flat bones are like interwoven fingers designed for expansion and contraction.  Similar to joints on a bridge that allow the materials to expand and contract to accommodate for changes in climate, suture joints allow for fluctuation in the volume of fluid around the brain.  

Cerebrospinal fluid (CSF) surrounds the brain and spinal cord cushioning these vital organs from impact and providing nutrients.  CSF travels with the blood.  When it reaches the entry point of the central nervous system, CSF is allowed to pass through the blood brain barrier as it enters the highly protected area of the central nervous system (the brain and spinal cord).  This circulation of CSF occurs like a slow draining sink.  It is constantly flowing back to the bloodstream to be replenished at a slow, steady rate.  But it flows into the central nervous system half the time, twice as fast.  So imagine watching the sink drain.  When the fluid reaches a threshold, the faucet is turned on and the sink fills to the brim.  The faucet is turned off and once again the sink drains to a threshold which triggers the filling phase to begin again.  This cycle of circulation of CSF is called the craniosacral rhythm.  Analogous to the respiratory cycle of breathing and the circulatory cycle of blood, the craniosacral rhythm is a subconscious function of the body.  

Therapeutically, we use the craniosacral rhythm to identify areas of dysfunction throughout the body.

When all the cranial and facial bones are moving efficiently, symmetrical movement is felt throughout the cranium.  But if there are restrictions in the suture joints or the intracranial membranes that anchor on the cranial bones we will feel one side expand further than the other.  This is a clue that something is limiting mobility and needs treatment.  These imbalances lead to inflammation of structures of the cranium, such as the TMJ or cranial nerves, and lead to symptoms such as facial pain, headaches, and tinnitus.   Because of the long reach of the Vagus nerve from the brainstem to the viscera, intracranial restrictions can even be the cause of digestive or reproductive issues and even mental health imbalances.