Thursday, November 02, 2006

Equine Cranialsacral Therapy 2

Equine Craniosacral Devotees are really big on solving the terrible issue of Temporomandibular Dysfunction, or TMD. Luckily, pioneer Maureen Rogers has provided an article on this malady, though most Equine Craniosacral Woo Sites go on at length about it.

When these bones are misaligned and not articulating properly and the surrounding tissue of the TMJ is stressed, the TMJ Mechanism is out of balance and cannot function optimally. This condition is known as Temporomandibular Dysfunction, or TMD.

We all know how distressing it is for any altie practitioner to find anything out of balance.

TMD affects overall health. Indicators of a TMD condition include popping and clicking in the joint area, headaches, bite misalignment, and gritting of the teeth. If the condition is left untreated, the cartilage that makes up the articular disc that allows the mandible to move will be worn down and damaged. In severe cases of TMD, the precious cartilage is completely worn away. The condition known as TMD occurs in all horses regardless of discipline. Horses exhibit signs of possible TMD discomfort in several different ways. TMD goes hand-in-hand with the misalignment of the upper and lower incisors and/ or any imbalances that may appear in the wear of the teeth, such as hooks or waves, and each perpetuates the other.

TMD shows up in many different shapes and sizes and cases differ in levels of severity. Horses with TMD will clearly show low levels of performance, improper gaits, uneven wear of the teeth, possible head shaking, signs of headaches, cribbing and/or various behavior problems. In some cases, even a slight retrusion in the lower jaw can be seen - the lower incisors of the mandible come behind the upper incisors of the maxilla. Any horse that has TMD will have some level of difficulty in performance. [...] Other indicators of possible TMD and/or dental problems may be ear sensitivity, head tossing, difficulty taking the bit in the mouth, leaning on the bit, difficulty with specific leads or gaits, difficulty flexing at the poll, signs of headaches, head shyness, and/ or sensitivity to any touch in the jaw area.

In other words, TMD can cause almost any signs and conditions. Every horse is sure to have it to a lesser or greater extent. Probably greater. You can, however, check your own horse for this devastating condition.

A way to check to see if your horse has any form of TMD is to look at how your horse’s incisors align. The upper six incisors should align with the lower set, directly in the middle. If you see a pull to one side or the other, it is likely that your horse has some discomfort with its TMJ Mechanism. Even though the teeth may align, the muscles that make up the TMJ may still be tight, causing discomfort.

Which seems a rather pointless test if you horse can have the condition whether his teeth align or not. Like subluxations for chiropracters, TMD is a condition that every horse (by the altie explanation of the dis-ease) will have (and, of course, CranioSacral Therapy can cure it, just as chiropractic manipulation can cure subluxations). Ms Rogers provides various images of misaligned horse teeth indicative of TMD, but EoR has doubts about these. Any horse having its mouth held open by pulling its lips apart will resist this action. Such resistance can include twisting the head and jaw from side to side. Still images, as Ms Rogers uses, are inconclusive in establishing any misalignment of teeth (which, if established, may or may not relate to TMD).

Dentistry alone cannot fix this problem:

The soft tissue must be addressed and treated, as well as the energy patterns holding the TMJ in a "dysfunctional pattern". Depending on the length of time the condition has existed, it may have worked its way through the entire body, causing the horse to compensate in his work, thus unbalancing him and inhibiting his performance and athletic abilities.

TMD is a real condition (at least, in humans):

This condition is sometimes called facial arthromyalgia but many other names are used. In some cases the joint itself is causing problems, in others, it is the muscles. The pain is in the form of a dull ache that affects the jaw and muscles in the side of the face near the ear. It may also cause clicking of the jaw and difficulty in opening the mouth because of spasm in the jaw muscles. The pain may extend over the side of the head and down into the neck. Often pain may be felt in the ear, where there may also be a sense of fullness or buzzing. It may sometimes be accompanied by dizziness. The cause of this pain is unknown, although for some the problem is a product of disease in the jaw joint. It can also occur when the teeth do not align properly. This can happen when teeth have been lost or if dentures do not fit well. Treatment will therefore begin with a careful assessment by a dental specialist. It is important not to have any treatment that is irreversible as the condition clears up in most cases within two to three years.

In humans, you're better off seeing an otolaryngologist.

If the doctor diagnoses your case early, it will probably respond to these simple, self-remedies:
  • Rest the muscles and joints by eating soft foods.

  • Do not chew gum.

  • Avoid clenching or tensing.

  • Relax muscles with moist heat

Craniosacral woos are not the only people who believe they have a god-given gift to resolve TMD (EoR also enjoyed this man's assertion that he could have cured Beethoven's deafness):

Generally speaking, providing that the condition has been correctly diagnosed, a doctor or specialist is the last person able to carry out correct treatment. Because very few have been trained and achieved experience in the technicalities of mechanically sorting out the problem and resulting ramifications. By correct treatment I mean actually correcting the subluxed (twisted) joint, and furthermore tracing and correcting any other factors due to compensations arising as a result of the TMJ condition.

EoR was unable to locate any reference to TMD or facial arthromyalgia in his veterinary reference books in relation to horses (though there's a lot of altie sites on the net promoting it). He did find a case study of Temporomandibular Septic Arthritis in a Horse, though this was resolved with antibiotics, general anaesthetic and a bone saw as opposed to very light hand touches. The discussion in this paper states:

Temporomandibular pain and dysfunction are common in human beings but relatively rare in animals. Horses are no exception, in part due to the stability rendered by the equine tight temporomandibular joint capsule, fibrous lateral and elastic caudal ligaments, and overlying musculature. Reports of temporomandibular joint abnormalities in the horse are mainly focused on traumatic subluxation either with or without an associated fracture of the vertical mandibular ramus, however a few case reports of septic temporomandibular arthritis do exist.

While undoubtedly some horses have problems with the TMJ joint, and quite a few horses have less than perfectly aligned teeth (as well as legs - why not blame the problems on those instead?), it appears TMD is being overpromoted by these woo therapists without any proper diagnosis (of course, no good altie therapist bothers with a diagnosis anyway), a whole dose of worrying information for the owner about various possibilities that may or may not exist, and then applying a disproven, impossible "rebalancing" in exchange for money.

1 comment:

  1. Thanks for that follow-up. I was worried that I had missed important scientific studies about TMJ in horses, so I contacted my good friend who's editor of a major horse health magazine, and she gave me the name and e-mail of a top (reputable) U.S. vet and dentist. But before I could contact him about TMJ and horses, you published your second report on Equine Cranialsacral (head-butt?) therapy and TMJ dysfunction (or lack thereof) in horses.

    Good to know I haven't been missing anything.

    I do so enjoy The Second Sight and its critcal view of horse woo. I get sad sometimes that horse people are such particular suckers.

    -- Folderol


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