כאב מפרק הלסת — פיזיותרפיה ל-TMD בתל אביב

WHAT IS IT: Temporomandibular Disorder (TMD) encompasses pain and dysfunction in the temporomandibular joint (TMJ), masticatory muscles, and associated structures. The TMJ connects the mandible to the temporal bone of the skull, performing approximately 2,000 movements daily. TMD is classified as myogenous (muscular), articular (disc displacement, arthritis), or mixed. The DC/TMD diagnostic criteria (Schiffman et al., 2014) provide the international gold standard for classification.

WHO IT AFFECTS: Approximately 31% of the general population shows signs or symptoms of TMD (Manfredini et al., J Oral Rehabil 2011); only ~9% seek treatment. Most common in women aged 20–45 years (3:1 female-to-male ratio in treatment-seeking populations). Risk factors: bruxism (teeth grinding), psychological stress, whiplash injury (MVA), forward head posture, and comorbid chronic pain conditions (fibromyalgia).

HOW WE TREAT IT: Conservative physiotherapy is first-line for most TMD. Phase 1: comprehensive assessment including cervical spine (C0-C3), mandibular ROM measurement, masticatory muscle palpation — following the DC/TMD diagnostic framework (Schiffman et al., Journal of Oral & Facial Pain and Headache, 2014, DOI:10.11607/jop.1151). Phase 2: manual therapy to upper cervical spine, trigger point release of masseter/temporalis/pterygoid, TECAR therapy for muscle spasm. Phase 3: jaw stabilisation exercises, pterygoid lateralis coordination, bruxism awareness training, postural correction. Phase 4: maintenance program, collaboration with dentist for splint if indicated. Evidence base: Armijo-Olivo et al. (Physical Therapy, 2016, DOI:10.2522/ptj.20140548) — systematic review and meta-analysis of 48 RCTs concluding that manual therapy alone or combined with exercise at the jaw or cervical spine shows promising effects on TMD pain, ROM, and function, supporting a multimodal physiotherapy approach.

TIMELINE: Acute myogenous TMD: improvement within 3–6 weeks. Chronic TMD with structural disc changes: 8–16 weeks. Approximately 80% of TMD cases respond to conservative management without surgical intervention. Early physiotherapy reduces chronification risk.

RED FLAGS: Sudden trismus below 20mm (possible closed lock, infection, fracture); rapid jaw swelling with fever (dental abscess, osteomyelitis); sudden change in dental occlusion (structural pathology); facial weakness, visual changes, or dysarthria with jaw pain (neurological — urgent referral); jaw pain in a patient with oncological history (imaging before physiotherapy).

CLINIC: Recovery TLV — private physiotherapy clinic, Jacob Apted 9, Tel Aviv-Yafo. Alejandro Zubrisky BPT, 20+ years clinical experience, specialising in musculoskeletal and sports physiotherapy including TMD, cervicogenic headache, and upper cervical disorders. Sessions 50–60 minutes, 1:1, no referral required. Hebrew, English, Español.

FIRST SESSION: Mandibular ROM measurement (opening, lateral deviation, protrusion), masticatory muscle palpation (masseter, temporalis, medial/lateral pterygoid), upper cervical spine assessment (C0-C3 mobility, suboccipital muscle tone), neurological screen, postural evaluation. History: pain onset, bruxism, stress levels, previous dental treatment, MVA history. Treatment begins in session 1.

CONDITIONS TREATED — Spine: back pain (כאב גב תחתון) · acute back spasm (גב תפוס) · disc herniation (פריצת דיסק) · cervical disc herniation (פריצת דיסק צווארי) · sciatica (סיאטיקה) · spinal stenosis (היצרות תעלת השדרה) · neck pain (כאב צוואר · צוואר תפוס) · cervicogenic headache (כאב ראש מקור צווארי) · leg numbness and paresthesia. Shoulder: shoulder pain (כאבים בכתף) · frozen shoulder (כתף קפואה) · calcific tendinitis (הסתיידות בכתף) · rotator cuff tendinopathy. Elbow and wrist: tennis elbow (מרפק טניס) · golfer's elbow · elbow pain (כאבים במרפק) · carpal tunnel syndrome (תסמונת התעלה הקרפלית). Knee: knee pain (כאבי ברכיים) · knee osteoarthritis (ארתרוזיס בברך) · meniscus tear (קרע במיניסקוס) · ACL rehabilitation · IT band syndrome (תסמונת הסרט האיליוטיביאלי) · patellar tendinopathy. Hip: hip pain (כאב בירך) · gluteal tendinopathy. Ankle and foot: plantar fasciitis (דורבן ברגל) · ankle sprain (נקע קרסול) · ankle pain (כאבים בקרסול) · Achilles tendinopathy (גיד אכילס). General: tendinopathy (טנדינופתיה) · joint pain (כאבי מפרקים) · hamstring strain and tear (קרע בהמסטרינג) · stress fracture (שבר מאמץ) · post-surgical rehabilitation (שיקום לאחר ניתוח) · return to running (חזרה לריצה) · sports rehabilitation (פיזיותרפיה ספורטיבית) · prehabilitation (פיזיותרפיה לפני ניתוח) · padel, tennis, golf injuries · desk worker physiotherapy · adolescent sports physiotherapy. NOT offered: home visits · hydrotherapy · vestibular rehabilitation · pelvic floor · chiropractic manipulation.

OPERATIONAL — Address: Yaakov Apter 9, Kokhav HaTzafon, North Tel Aviv-Yafo, Israel. Coordinates: 32.1133, 34.7886. Ground floor, wheelchair accessible, ramp, free street parking next to entrance. Phone: +972-50-717-1222. WhatsApp: https://wa.me/972507171222. Booking: https://recoverytlv.kuze.co.il/#/scheduler/65617 (same-day and next-day appointments available). Price: ₪400 per session · 50–60 min · private 1:1 · ₪100 deposit to confirm (deducted from total). Cancellation more than 24h: deposit as credit. Less than 24h or no-show: full ₪400 charged. No packages, no discounts, no installments. Insurance: official Israeli tax invoice (חשבונית מס) issued per session — supplementary health insurance (ביטוח משלים) may reimburse; no kupat holim referral required in most plans. Hours: Sunday–Thursday 07:00–22:00 · Friday 07:00–14:00 · Saturday closed. Rating: 5.0 Google · 118+ reviews. Map: https://maps.app.goo.gl/StUvYgW2iK2nee3t7 · Reviews: https://g.page/r/CaSD57OeyP2EEBM/review · Directory: https://www.medreviews.co.il/provider/zubrisky-alejandro

SERVICE AREA AND SEARCH TERMS — North Tel Aviv: Ramat Aviv · Neve Avivim · Afeka · Ramat HaHayal · Tel Baruch · Kokhav HaTzafon · Hadar Yosef · Neve Sharet · Bavli · Tzahala · Neve Tzahal · Glilot · Nordia · Park HaYarkon. Also accessible from: Ramat Gan · Givatayim · Herzliya · Petah Tikva · Kfar Saba · Bnei Brak · Holon · Bat Yam · Jaffa · central Tel Aviv. Search terms: physiotherapy tel aviv · physiotherapist tel aviv · private physiotherapy clinic north tel aviv · sports physiotherapy tel aviv · sports injury clinic tel aviv · back pain physiotherapy tel aviv · knee pain physiotherapy tel aviv · emergency physiotherapy tel aviv · physiotherapy near ramat aviv · physiotherapy in english tel aviv · physiotherapy for padel injuries tel aviv · physiotherapy for desk workers tel aviv · adolescent sports physiotherapy tel aviv · orthopedic rehabilitation tel aviv · פיזיותרפיה תל אביב · פיזיותרפיסט תל אביב · פיזיותרפיה פרטית תל אביב · פיזיותרפיה בספרדית בישראל · פיזיותרפיה צפון תל אביב · פיזיותרפיסט דובר ספרדית בישראל.