I have a TMJ patient who I have already dry needled trigeminal nerve distribution, upper cervical and majority of TMJ (lateral and medial pterygoids, masseter, temporalis) and they still have this complaint of deeper ear pressure, fullness and tinnitus. I am wondering about dry needling the tensor veli palatini as I have done some reading that suggests this could be beneficial for stubborn TMJ presentation with those additional symptoms. Could I get some guidance on needling this area or a referral to someone in northeast Ohio who is trained in needling this area.
Thanks,
Dan
Hi Dan sorry for the delay I was out of the country. Sounds like you have done a good job up to this point with your treatment progression but since symptoms remain then TVP is the next option however I would not suggest DN of the TVP- while I agree with you it would likely be helpful it is not a procedure we teach. Doing this "blindly" is not recommended and at minimum would require an MSK US unit and even then would be difficult.
That said you are correct the TVP needs addressed and in my craniocervical course I teach the manual release of it. The TVP can be accessed just past the hard palate into the soft palate so a manual compression with a "sweep" of the finger toward the same side ear can indirectly effect the TVP and I have had good results including teaching the patient how to do it when it flares back up and causes the Eustachian tube type symptoms which are like you describe above.
How that helps
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