BACKGROUND: Many practitioners have found that posture training has a positive impact on temporomandibular, or TMD, symptoms. The authors conducted a study to evaluate its effectiveness. METHODS: Sixty patients with TMD and a primary muscle disorder were randomized into two groups: one group received posture training and TMD self-management instructions while the control group received TMD self-management instructions only. Four weeks after the study began, the authors reexamined the subjects for changes in symptoms, pain-free opening and pressure algometer pain thresholds. In addition, pretreatment and posttreatment posture measurements were recorded for subjects in the treatment group. RESULTS: Statistically significant improvement was demonstrated by the modified symptom severity index, maximum pain-free opening and pressure algometer threshold measurements, as well as by the subjects' perceived TMD and neck symptoms. Subjects in the treatment group reported having experienced a mean reduction in TMD and neck symptoms of 41.9 and 38.2 percent, respectively, while subjects in the control group reported a mean reduction in these symptoms of 8.1 and 9.3 percent. Within the treatment group, the authors found significant correlations between improvements in TMD symptoms and improvements in neck symptoms (p < 0.005) as well as between TMD symptom improvement and the difference between head and shoulder posture measurements at the outset of treatment (p < 0.05). CONCLUSIONS: Posture training and TMD self-management instructions are significantly more effective than TMD self-management instructions alone for patients with TMD who have a primary muscle disorder. PRACTICE IMPLICATIONS: Patients with TMD who hold their heads farther forward relative to the shoulders have a high probability of experiencing symptom improvement as a result of posture training and being provided with selfmanagement instructions.

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