The temporomandibular joint dysfunction is the second most common musculoskeletal pain after back pain, causing jaw pain, restricted movement, and joint sounds. NPRS and millimeter ruler will be used for the assessment of patient. This study will compare the effects of Mulligan and Maitland mobilization, commonly used treatment, on pain and Temporomandibular joint mobility through a randomized controlled trial, involving 30 participants divided into two groups for treatment.
Age 19-44 years.
Both Genders (Male and Female).
Patients diagnosed with TMJ hypomobility using the Manual Functional Analysis questionnaire based on DC/TMD criteria.
Individuals with myofascial pain, scoring above 5 on the NRS and pain upon palpation of at least two of eight masticatory and neck muscles.
Hypermobility of TMJs.
Pregnancy.
History of rheumatic and inflammatory diseases.
A history of temporomandibular disorders treatment within last three months.
Parallel
Mulligan Mobilization
Procedure/SurgeryBoth Mulligan and Maitland mobilization techniques with Myofascial release of temporalis and masseter and Rocabado 6\*6 exercise program are applied over a two-week period with six sessions in total, focusing on improving TMJ mobility and reducing pain. Group A Mulligan mobilization emphasizes active patient involvement combined with therapist-applied glides, including lateral, anterior, medial, and distraction glides performed for 5-10 seconds with 3-5 repetitions per session. These techniques enhance mouth opening, lateral deviation, protrusion, and joint space while reducing stiffness and pain. And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6\*6 exercise program
Maitland Mobilization
Procedure/SurgeryGroup B-Maitland mobilization relies on graded oscillatory movements (Grades I-III) for 5-10 seconds with 3-5 oscillations, targeting pain relief and mobility in the pain-free range. Lower grades (I-II) are used for acute pain with gentle oscillations, while higher grades (II-III) provide moderate mobilization to improve protrusion, lateral deviation, and joint capsule mobility. And baseline treatment of myofascial release of temporalis and masseter muscle and Rocabado's 6\*6 exercise program.
Pain intensity
Pain will be measured through Numeric Pain Rating Scale. The scoring for NPRS involves a scale from 0 to 10, where 0 indicates no pain. The interpretation of scores is as follows: 0 to 3 for mild pain, 4 to 6 for moderate pain, and 7 to 10 for severe pain.
Temporomandibular joint Hypomobility
Mandibular movements were assessed using a millimeter ruler to measure depression (50-60 mm), protrusion (5 mm), and lateral deviation (12-15 mm). Any "click" sounds or deviations during movement were recorded. Jaw movements maintained upper and lower teeth contact.
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