In myogenous temporomandibular disorder (TMD), a supported self-management programme is the recommended first step. When that programme does not deliver adequate reduction in pain intensity and pain-related disability, a structured next-line protocol is indicated.
This protocol addresses myogenous temporomandibular disorder — a muscle-origin subtype of TMD — specifically in patients who have completed a first-line supported self-management plan without meeting the expected pain and functional targets.
The prior step was Supported Self-Management (SSM), which included education, self-exercise therapy, thermal modalities, self-massage, dietary and nutritional guidance, and modification of parafunctional behaviour.
Escalation is triggered when SSM has not achieved sufficient reduction in pain intensity and pain-related disability.
This protocol adds structured adjunctive interventions alongside continued SSM. The approach draws on a combination of physical, device-based, and psychological modalities — with several components specifically supported by evidence in myogenous TMD.
The clinical goals are decreased pain and increased range of jaw movement and function.