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Jaw Osteomyelitis Physiotherapy

Osteomyelitis refers to an infection of the bone.

The temporomandibular joint  (TMJ) is rarely affected by osteomyelitis, but when it is, it will require immediate medical attention. Lack of jaw and neck mobility may occur during and after the infection, and physiotherapy will help improve your jaw mobility to

  • restore your ability to eat and speak
  • and brush your teeth

What Is Osteomyelitis of the Jaw?

Osteomyelitis is an infection of the bone and most commonly affects the bones of the extremities, spine, and pelvis. The temporomandibular joint (TMJ) is rarely affected by this condition, but when it is, serious problems with the bones of the face and jaw can result.

Usually, the infection is the result of bacteria entering the body through poor oral hygiene or oral surgery, such as a root canal procedure. It also may occur following a jaw fracture. Osteomyelitis in the jaw occurs more in men than women, and more commonly in the mandible (lower jaw bone) than the maxilla (bone where the top teeth are arranged).

People with diabetes, have alcoholism, or any other diseases that impact the immune system are at greater risk of getting this condition. Also, having had another recent surgery before oral surgery or jaw trauma may increase risk, also.

To heal the infected bone, the body sends white blood cells to the area; however, persistent presence of white blood cells near the bone actually causes the bone to break down. The infection restricts blood flow to the area and causes bone death ("necrosis").

Signs and Symptoms

Osteomyelitis of the jaw can cause:

  • Fever
  • Jaw pain
  • Facial swelling
  • Tenderness to the touch
  • Jaw stiffness
  • Sinus drainage
  • Tooth loss
  • Pus (thick, usually yellow-white fluid)
  • A palpable bump on the bone of the jaw
  • Fatigue
  • Fever
  • Headaches or neck ache

During the acute stage of osteomyelitis, you'll have increasing, constant jaw pain and sinus pressure that is not affected by movement of the jaw. If you have chronic osteomyelitis, you may have jaw and neck stiffness, and difficulty with eating and talking.

How Is It Diagnosed?

A series of blood tests usually is ordered to check for elevated white blood cell counts.

This condition is often misdiagnosed because its symptoms are similar to other jaw, skull, or face problems. Bone changes and inflammation may be observed in medical images (x-ray, ultrasound, CT, or MRI) of the jaw, as well.

If osteomyelitis is found to be the cause of your pain, your physician will prescribe antibiotics to clear up the infection. Occasionally, there is difficulty opening the mouth, normally due to tissue damaged by the inflammation. It's in these cases where physiotherapy will help restore motion and decrease pain in the jaw area.

Your doctor or dentist will inform our senior physiotherapists what specific areas were impacted by the infection. We then can help you

  • restore the normal motion and mobility of those structures
  • reduce your pain
  • gain the ability to speak, eat, and maintain oral hygiene

how our senior physiotherapists can help

Our senior physiotherapists can help restore the natural movement of your jaw and decrease your pain; but first, we and you need the antibiotics to take effect. After you've finished your course of antibiotics, you might have pain and limited movement at the TMJ and cervical spine. You also may have headaches.

During your first visit with your physical therapist, the therapist will:

  • Review your medical history, and discuss any previous surgery, fractures, or other injuries to your head, neck, or jaw
  • Conduct a physical examination of your jaw and neck
  • Evaluate your posture and how your neck moves
  • Examine the TMJ to find out how well your mouth can open and whether there are any abnormalities in jaw motion as a result of the osteomyelitis

We might place his or her hand in your mouth in order to examine your jaw movement. Following the examination, we will select appropriate treatments to improve jaw movement and relieve pain.

Improve Jaw Movement

We use skilled hand movements called manual therapy  to increase movement and relieve pain in tissues and joints. We also might use manual therapy to “stretch” the jaw to:

  • Restore normal joint and muscle flexibility (so that your jaw won't feel "tight")
  • Break up the scar tissues ("adhesions") that may occur when disease or injury limits movement for a period of time

We may teach you special "low-load" exercises. These are exercises that don't exert a lot of pressure on your TMJ but can strengthen the muscles of the jaw and restore a more natural, pain-free motion.We will also teach you exercises that help you increase the opening of your jaw and improve the way your jaw works

Relieve Your Pain

In addition to manual therapy, if your pain is severe, our senior physiotherapists might use treatments such as

to reduce pain.