1. Derangement of the joint disc. The disc is a small, flat, fibrous mass which rests between the bones of the joint. A "click" or "pop" is often heard when opening the mouth.

2. Joint capsule restriction is characterized by the progressive shortening of the ligaments, which connect the bones of the jaw. This may follow immobilization of the joint or trauma. This condition may occur together with a disc derangement.

3. Subluxation or displacement of the bone surfaces when opening the mouth is often caused by imbalances in the flexibility of the muscles that control opening.

All the conditions can cause pain directly at the jaw, headache, restricted jaw motion and irregular movement patterns at the jaw.

• Degenerative Joint Disease
• Degenerative Disc Disease
• Herniated Disc
• Whiplash
• Sprain/Strain
• Torticollis (Wry Neck)
• Facet Impingement

Degenerative Joint Disease--DJD is a common and painful condition affecting the spine's facet joints. The condition can involve one or many facet joints along the length of the spine. However, it is most common at the neck and low back. DJD, often referred to as spondylosis or simply arthritis, is characterized by the gradual wearing away of the protective cartilage which coats the facet joints. The cartilage is worn by repetitive pressure and contact on the joint surface. Once the cartilage is reduced, the highly sensitive bone surface is exposed and is subject to the joint pressure and contact. The pressure and contact often leads to chronic inflammation, pain and, occasionally, to the formation of "bone spurs". DJD often occurs together with Degenerative Disc Disease.

Degenerative Disc Disease--DDD is characterized by the gradual narrowing of the intervertebral discs which separate or space the vertebrae and facet joints. As the discs narrow, the facets are allowed to come in contact with one another leading to Degenerative Joint Disease. The narrowing also reduces the foramen or windows that the nerves pass through as they exit the spinal canal. Any contact with the nerves can lead to pain and other sensory disturbances at the spine and the extremities. This condition is often referred to as a "pinched nerve" or if occurring at the low back, "sciatica."

Herniated Disc--Intervertebral discs serve to separate or space the spine's vertebrae, lend the spine its flexibility, and absorb compressive forces. Each disc has a soft nucleus and a tough outer wall. Occasionally, either through a singular trauma, repetitive stress, or poor posture, the nucleus can be displaced and pass partially through the disc wall. This creates a bulge or protrusion which leads to back pain. (If the nucleus passes completely through the disc wall, the disc is said to be ruptured.) Unfortunately, the spine is constructed so that even small protrusions can compress the spinal nerve root exiting the spine. Any nerve contact leads to pain and other sensory disturbances at the spine and extremities. This condition is often referred to as a "pinched nerve" or if occurring at the low back, "sciatica."

Whiplash--A soft tissue injury involving the ligaments and muscles which surround the neck. Whiplash is typically the result of a motor vehicle accident, but may be caused by any force causing the neck to rapidly accelerate and decelerate in both forward and backward directions. The soft tissue often tears in multiple locations. The tearing creates pain, inflammation and immobility.

Sprain/Strain--Strictly speaking, a sprain is a ligament tear, while a strain is a muscle tear. Ligament and muscle both may suffer from varying degrees of tearing. The tearing may be caused by overexertion, movement which exceeds the available range of motion, sudden, uncoordinated or unanticipated movement, a direct blow, or other cause. A sprain or strain is characterized by local pain, local inflammation and usually some degree of lost motion and/or strength. The more severe the sprain/strain, the greater the disability, and the longer the recovery.

Torticollis (Wry Neck)--Torticollis is the acute spasm of either the left or right sternocleidomastoid muscle in the front of the neck. The sternocleidomastoids run diagonally from behind the ear to the clavicle, or collar bone.

Facet Impingement--Facets are small bony prominences which project from the back of each vertebra. Each vertebra has two facets, one on the left, the other on the right. The facets of each vertebra join the facets from the vertebrae above and below to form facet joints. A locking or malalignment of these facet joints is a common injury. A facet injury often occurs without trauma and may simply be the result of a sudden movement of the neck or low back. A facet impingement results in a loss in range of motion, considerable local pain and inflammation, and is usually accompanied by some degree of local muscle spasm.

• Tendonitis
• Bursitis
• Rotator Cuff Repair
• Adhesive Capsulitis (Frozen Shoulder)
• Thoracic Outlet Syndrome

Tendonitis Shoulder--Tendonitis involves "micro" tearing of the tendon fibers and secondary inflammation and pain. The condition is characterized by weakness of the involved tendon and a loss in range of motion. Because the shoulder has been designed to provide maximum mobility, its tendons are susceptible to both overuse and impingement by surrounding structures. Several tendons pass through the shoulder. The rotator cuff tendon is actually a combination of the supraspinatus, infraspinatus, and teres minor tendons. The bicipital tendon also passes through the shoulder.

Bursitis Shoulder --A bursa is fluid filled sack which resides near many of the body's joints. Bursae secrete fluid to help lubricate bone surfaces during activity. Bursae may become inflamed and painful if repetitively compressed or irritated, or if directly struck by an external force. 

Rotator Cuff Repair--The rotator cuff is a group of muscles which attach to both the shoulder blade (scapula), and the front of the shoulder. These muscles help to rotate the shoulder and lift it from the side. The cuff also decelerates the arm in the follow-through of a throwing motion and acts to maintain proper spacing between the bone surfaces of the shoulder joint. When subjected to repetitive compression or irritation, or the recipient of one singular and excessive force, the cuff may tear. The rotator cuff generally tears near its insertion into the front of the shoulder where the muscle becomes tendon. Because tendons have limited blood flow, any significant tear is not likely to heal. Therefore, surgery is often required.

Adhesive Capsulitis (Frozen Shoulder)--The typical joint is surrounded by a capsule of ligaments. The ligaments connect the bones which form the joint and provide stability. Immobilization or injury to the joint can diminish the mobility of the ligaments. Individual fibers which make up the ligamentous capsule can both shorten and adhere to each other when immobile or following trauma. Occasionally, however, the capsule can spontaneously develop significant losses in mobility without immobilization or trauma. The loss in flexibility limits range of motion, creates significant pain and loss of functional capacity.

Thoracic Outlet Syndrome--Thoracic Outlet Syndrome (TOS) is characterized by the compression of the nerves and/or blood vessels that pass from the base of the neck through the shoulder. The compression leads to variety of symptoms including pain, tingling, and numbness at the arm and circulatory problems. The condition has many causes, including poor posture, tight muscles surrounding the neck and chest, and even compression by an extra rib located near the top of the spine.

• Carpal Tunnel Syndrome
• Tendonitis

Carpal Tunnel Syndrome--Carpal tunnel syndrome is defined as compression of the median nerve as it passes between the bones of the wrist/hand and the transverse carpal ligament. When compressed, the symptoms include tingling, numbness and pain in the fingers and hand. The symptoms are often worse at night.

Tendonitis Wrist/Hand--Tendonitis involves "micro" tearing of the tendon fibers and secondary inflammation and pain. The condition is characterized by weakness of the involved tendon and a loss in range of motion. At the wrist, tendonitis is often due to overuse

• Sacroiliac Joint Dysfunction
• Sciatica
• Degenerative Disc Disease
• Degenerative Joint Disease
• Facet Impingement
• Herniated Disc
• Sprain/Strain

Sacroiliac Joint Dysfunction--Sacroiliac Joint Dysfunction (SI) Dysfunction is often used generically to describe a multitude of mechanical disorders involving the pelvis.  The pelvis is comprised of three large bones, which are tied together with a large network of ligaments.  Despite the stability offered by the ligaments, the bones can move or shift in a variety of ways, usually secondary to trauma, but often due to pregnancy.  The displacement of the bones creates joint pain, puts undue stress on the muscles and ligaments of the pelvis and can even irritate or compress nerves traveling to the legs.

Sciatica--A generic term referring to pain and sensory disturbances at the leg or legs caused by the irritation or compression of a spinal nerve at the back or pelvis.

Degenerative Disc Disease Low Back--DDD is characterized by the gradual narrowing of the intervertebral discs which separate or space the vertebrae and facet joints. As the discs narrow, the facets are allowed to come in contact with one another leading to Degenerative Joint Disease. The narrowing also reduces the foramen or windows that the nerves pass through as they exit the spinal canal. Any contact with the nerves can lead to pain and other sensory disturbances at the spine and the extremities. This condition is often referred to as a "pinched nerve" or if occurring at the low back, "sciatica."

Degenerative Joint Disease Low Back--DJD is a common and painful condition affecting the spine's facet joints. The condition can involve one or many facet joints along the length of the spine. However, it is most common at the neck and low back. DJD, often referred to as spondylosis or simply arthritis, is characterized by the gradual wearing away of the protective cartilage which coats the facet joints. The cartilage is worn by repetitive pressure and contact on the joint surface. Once the cartilage is reduced, the highly sensitive bone surface is exposed and is subject to the joint pressure and contact. The pressure and contact often leads to chronic inflammation, pain and, occasionally, to the formation of "bone spurs". DJD often occurs together with Degenerative Disc Disease.

Facet Impingement Low Back--Facets are small bony prominences which project from the back of each vertebra. Each vertebra has two facets, one on the left, the other on the right. The facets of each vertebra join the facets from the vertebrae above and below to form facet joints. A locking or malalignment of these facet joints is a common injury. A facet injury often occurs without trauma and may simply be the result of a sudden movement of the neck or low back. A facet impingement results in a loss in range of motion, considerable local pain and inflammation, and is usually accompanied by some degree of local muscle spasm.

Herniated Disc--Intervertebral discs serve to separate or space the spine's vertebrae, lend the spine its flexibility, and absorb compressive forces. Each disc has a soft nucleus and a tough outer wall. Occasionally, either through a singular trauma, repetitive stress, or poor posture, the nucleus can be displaced and pass partially through the disc wall. This creates a bulge or protrusion which leads to back pain. (If the nucleus passes completely through the disc wall, the disc is said to be ruptured.) Unfortunately, the spine is constructed so that even small protrusions can compress the spinal nerve root exiting the spine. Any nerve contact leads to pain and other sensory disturbances at the spine and extremities. This condition is often referred to as a "pinched nerve" or if occurring at the low back, "sciatica."

Sprain/Strain Low Back--Strictly speaking, a sprain is a ligament tear, while a strain is a muscle tear. Ligament and muscle both may suffer from varying degrees of tearing. The tearing may be caused by overexertion, movement which exceeds the available range of motion, sudden, uncoordinated or unanticipated movement, a direct blow, or other cause. A sprain or strain is characterized by local pain, local inflammation and usually some degree of lost motion and/or strength. The more severe the sprain/strain, the greater the disability, and the longer the recovery.

• Bursitis
• Hip Replacement
• ACL Reconstruction
• Ligament Sprain
• Hamstring Strain

Bursitis Hip--A bursa is fluid filled sack which resides near many of the body's joints. Bursae secrete fluid to help lubricate bone surfaces during activity. Bursae may become inflamed and painful if repetitively compressed or irritated, or if directly struck by an external force. 

Hip Replacement--Hip replacements are done when the hip itself becomes so compromised that it is no longer allowing for an acceptable level of function and/or is the source of great pain. Severe arthritis is one condition which commonly precipitates a replacement. The surgical procedure involves replacing the ball at the top of the femur (thigh bone) and remodeling the socket (acetabulum) with a metal cup.

ACL Reconstruction--The Anterior Cruciate Ligament (ACL) runs between the end of the femur (thigh bone) and the top of the tibia (shin bone) in the center of the knee. It stabilizes the knee by preventing forward shearing. The ACL is torn by a combination of rotation, bending and a lateral or sideways force applied to the knee. Once torn, the ACL must be surgically reconstructed.

Ligament Sprain--A sprain, or tear, can involve few or many of the individual fibers which together make up the ligament. A sprain may involve very minimal fraying of the fibers or significant disruption. The knee includes many ligaments, but the two that are most often sprained are the medial collateral ligament (MCL) and the lateral collateral ligament (LCL). Both act as stabilizers, one on each side of the knee. They attach the femur (thigh bone) to the tibia (shin bone) and can be injured when a force is applied to the opposite side of the knee, stretching the ligaments beyond the available limits.

Hamstring Strain--The hamstring muscles travel from the back of the pelvis to the back of the knee. These long, powerful muscles are subject to injury if required to stretch beyond the available range of motion. The individual fibers of the hamstring may tear, creating local pain and inflammation. In more severe cases, significant discoloration and losses in motion, strength and function occur.

• Patello-Femoral Syndrome
• Meniscal Tear
• Knee Replacement
• Tendonitis

Patello-Femoral Syndrome (Chondromalacia Patellae)--The knee cap (patella) moves up and down in a bony groove at the end of the femur (thigh bone) when the knee is straightened and bent. If the patella collides with the surface of the groove during movement, the protective cartilage that lines its surfaces will progressively degrade. (A single blunt blow to the knee may facilitate cartilage degradation as well.) Beneath the cartilage is bone that is highly sensitive to this contact. Once the cartilage is degraded, it can not be regenerated. Progressive pain and inflammation follow as well as functional limitations. Ascending and descending stairs, kneeling and squatting are particularly problematic.

Meniscal Tear--Each knee has two menisci; one on the inside and one on the outside. The menisci are "sandwiched" between the top of the tibia (shin bone) and bottom of the femur (thigh bone), within the knee joint. Each meniscus is made up of cartilage, and serves to absorb shock and prevent the bone surfaces from coming into direct contact. Various compressive, shearing and rotatory forces applied directly to a meniscus may lead a tear. Because menisci have very limited blood flow, tears are generally incapable of healing on their own. If the tear leads to persistent pain, inflammation and functional losses, surgery is often required. It is, however, possible to treat a tear conservatively through physical therapy.

Knee Replacement--Knee replacements are done when the knee itself becomes so compromised that it is no longer allowing for an acceptable level of function and/or is the source of great pain. Severe arthritis is one condition that commonly precipitates a replacement. The surgical procedure involves replacing the ends of the thigh and shin bones (the femur and tibia) with metal components. These components can be either cemented or held in place by the gradual growth of bone which locks the replacement into position.

Tendonitis Knee--Tendonitis involves "micro" tearing of the tendon fibers and secondary inflammation and pain. The condition is characterized by weakness of the involved tendon and loss in range of motion.  Tendonitis at the knee typically involves the tendon directly above or below the knee-cap. Both are often the result of overuse of the quadricep muscle which is connected to the tendons and is used to extend, or straighten the knee.

Plantar Fasciitis--The plantar fascia is a band of tendon that connects the heel to the ball of the foot. The tension on the tendon maintains the arch of the foot. This fascia can become inflamed and painful when repetitively stretched beyond its available length. The fascia suffers micro-tears, usually at its origin at the heel. Improper foot alignment is a common cause, forcing a flattening of the arch. If the tension on the fascia persists, a bone spur may form at the heel. The spur further irritates the fascia and exacerbates the symptoms.

Achilles Tendonitis--Tendonitis involves "micro" tearing of the tendon fibers and secondary inflammation and pain.  The condition is characterized by weakness of the involved  tendon and a loss in range of motion.  The Achilles tendon connects the calf muscles to the back of the heel.  Tendonitis typically effects the tendon where it inserts into the heel.  It is caused by overuse, but may be due to a direct blow or a sudden stretch, taking the tendon beyond its available range of motion.  Overuse involves jumping activities or frequently standing on the balls of the feet.  Women who wear high heels often suffer a progressive shortening of the Achilles tendon, predisposing them to injury.

Ankle Sprain--An ankle sprain is probably the most common of all musculoskeletal injuries. A sprain involves the tearing of a ligament.  Though the ankle includes many ligaments, by far the most commonly injured is the anterior talo-fibular ligament.  It resides on the outside of the ankle and is injured when the ankle "rolls out."  Inflammation, discoloration, immobility and pain are the typical symptoms.  Weight bearing increases the pain.