Explanations and Advice

The first part of physiotherapy is a thorough assessment including your concerns, goals and aims. For some understanding what they are experiencing and the cause is the first and most important priority. For others, having the tools themselves to tackle their pain and dysfunction is their main aim and others want to commence hands on treatment immediately. It is my aim to deliver what is needed to each individual person. Advice is an ongoing fundamental part of physiotherapy. We can discuss any scans, procedures and referrals you have and can liaise with other healthcare professionals if required.

Joint mobilsations and manipulations

The first part of physiotherapy is a thorough assessment including your concerns, goals and aims. For some understanding what they are experiencing and the cause is the first and most important priority. For others, having the tools themselves to tackle their pain and dysfunction is their main aim and others want to commence hands on treatment immediately. It is my aim to deliver what is needed to each individual person. Advice is an ongoing fundamental part of physiotherapy. We can discuss any scans, procedures and referrals you have and can liaise with other healthcare professionals if required.

Soft tissue release, massage, trigger pointing

Soft tissue techniques are used to address musculoskeletal pain and muscle tension associated with temporomandibular disorders (TMD), neck pain, and certain types of headache. Treatment may focus on muscles of the jaw, face, neck, and upper shoulder region to reduce muscle tightness, improve tissue mobility, and promote relaxation. Intraoral massage may also be used to access the masticatory muscles, particularly the medial and lateral pterygoids, as well as the inner aspect of the masseter, where appropriate. This technique involves gentle pressure applied inside the mouth and should only be performed with informed consent, appropriate hygiene, and suitable clinical training. The jaw is often moving erroneously and can be rebalanced with this work and reduce pain, clicking and dysfunction. Trigger point release involves applying sustained pressure to sensitive areas within a muscle that may contribute to local or referred pain. Although these techniques are commonly focused on the cranio-cervical region in these conditions, soft tissue treatment can also be applied more broadly throughout the body where muscular tension or dysfunction may be contributing to symptoms. These interventions are generally used as part of a wider management programme, alongside exercise, education, and other appropriate treatments.

Anatomy trains, posture and ergonomics

The concept of Anatomy Trains describes the body as a series of interconnected myofascial chains, highlighting how movement and tension in one area may influence other regions. In relation to neck pain, temporomandibular disorders (TMD), and headaches, a whole-body assessment can therefore be useful when considering factors that may contribute to symptoms. Prolonged or sustained postures, particularly during desk work or device use, may place increased demands on the neck and upper body and contribute to muscular discomfort. Attention to ergonomics, regular movement, and maintaining comfortable, varied postures may help reduce unnecessary physical strain. Treatment and rehabilitation may therefore consider both the local area of symptoms and wider movement and postural habits.

At my clinic I practice western acupuncture. This is the practice of inserting sterile needles into the tissues in specific locations and can be carried out as a standalone treatment or as part of a wider range of physiotherapy treatments. Western acupuncture also uses the traditional meridian line acupuncture points as they are proven to stimulate the nervous system effectively but has adapted practice using current knowledge of anatomy, physiology and pathology. You may have also heard the term dry needling, which is the practice of inserting needles into muscle knots (also known as myofascial trigger points) and is a part of western acupuncture.

Acupuncture and Dry Needling

Physiotherapy can play an important role in the assessment and management of vestibular disorders. For benign paroxysmal positional vertigo (BPPV), canalith repositioning manoeuvres, such as the Epley manoeuvre, may be used to move displaced otoconia from the semicircular canals and reduce positional vertigo. Vestibular rehabilitation may also be used for a wide range of vestibular conditions and involves individualised exercises to improve gaze stability, balance, movement tolerance, and adaptation to dizziness. Treatment should be based on an appropriate assessment and tailored to the individual's specific diagnosis and symptoms.

BPPV and vestibular rehab

Exercise prescription and muscular re-training can form an important part of the management of TMD, neck pain, and some types of headache. Exercises may aim to improve muscle control, strength, endurance, mobility, and coordination within the jaw, neck, and shoulder regions. For TMD, this may include gentle jaw movement and control exercises, while neck rehabilitation may focus on improving the function and endurance of the cervical and surrounding musculature. A gradual, individualised programme can help patients improve movement confidence and return to normal daily activities, with exercises progressed according to symptoms and functional ability. Muscular restoration is proven to prevent recurrence.

Exercise prescription and muscle training

Transcutaneous electrical nerve stimulation (TENS) may be used as an adjunctive treatment for pain associated with temporomandibular disorders (TMD). By delivering low-voltage electrical stimulation through surface electrodes, TENS may help modulate pain and promote muscle relaxation, potentially reducing discomfort and improving jaw function. In trigeminal neuralgia, however, evidence for TENS is more limited, and it is generally not considered a primary treatment; medical management remains the mainstay of care. Other electrotherapy modalities that may be used in pain management include interferential therapy (IFT), neuromuscular electrical stimulation (NMES), and therapeutic ultrasound, although their use should be guided by the patient's diagnosis, clinical presentation, and the available evidence.

TENS and electrotherapy

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