Temporomandibular disorders and headaches Two pains, one face

The general aim of this dissertation was to establish evidence for the different steps in the physical therapeutic process for patients with TMD and headache. Headache is a common comorbid disorder (67 – 88%) in patients with a temporomandibular disorder (TMD). Patients presenting with both complaints may seek help from a specialized physical therapist, known in the Netherlands as an orofacial physical therapist (OPT). This dissertation demonstrates important information OPTs need when they see a patient with TMD and concurrent headache in the clinic. This information includes the prevalence of headache in patients with TMD, the association between headache and TMD, and the influence of other variables such as bruxism and psychosocial factors on this association, headache pain intensity, and pain-related disability. Secondly, an overview on the latest evidence on diagnostic measurement tools to identify headache is described. In order to screen for the presence of the most common primary headache disorders, migraine and tension-type headache (TTH), the headache screening questionnaire was developed and validated, which is also part of this dissertation. Treatment of the TMD may have a positive effect on the concurrent headache complaints, and e-Health can be useful to support the TMD-treatment. Finally, OPTs and patients stated that blended e-Health including exercise videos is a positive aspect of the physical therapeutic process.