Invasive surgical procedures in TMD may cause symptoms to worsen. Meniscectomy, also termed discectomy refers to surgical removal of the articular disc. This is rarely carried out in TMD, it may have some benefits for pain, but dysfunction may persist and overall it leads to degeneration or remodeling of the TMJ. Alternative medicine
Acupuncture
Acupuncture is sometimes used for TMD. There is limited evidence that acupuncture is an effective symptomatic treatment for TMD. A short-term reduction in muscular pain of muscular origin can usually be observed after acupuncture in TMD, and this is more than is seen with placebo. There are no reported adverse events of acupuncture when used for TMD, and some suggest that acupuncture is best employed as an adjuvant to other treatments in TMD. However, some suggest that acupuncture may be no more effective than sham acupuncture, that many of the studies investigating acupuncture and TMD have significant risk of bias, and that the long term efficacy of acupuncture for TMD is unknown. Chiropractic
Chiropractic adjustments (also termed manipulations or mobilizations) are sometimes used in the belief that this will treat TMD. Related conditions that are also claimed to be treatable by chiropractic include tension headaches and neck pain. Some sources suggest that there is some evidence of efficacy of chiropractic treatment in TMD, but the sources cited for these statements were case reports and a case series of only 9 participants. One review concluded "inconclusive evidence in a favorable direction regarding mobilization and massage for TMD".
Splinting
A contracture corrective device (CCD) is a dynamic splint that provides a continuous stretch with a continuous force and operates based on the principles of creep. It is the most advantageous splint but more research is required. Splints are used in long term treatments and must be removed in order to stretch the antagonist muscle to maintain range of motion (passive stretching). Electrical stimulation
Electrical stimulation improves passive range of motion but only temporarily. Once the treatment is withdrawn, all benefits are reduced. It can play a critical role in muscle atrophy prevention. Surgery
Surgery is a solution to muscle shortening but other complications may arise. Following muscle lengthening surgery, force production and ROM is usually reduced due to the shift in sarcomere locations between a muscles maximal and minimal length. Shortening of the surgically lengthened muscle can re-occur. == References ==