Are You Suffering from Jaw or TMJ Pain?

Jaw pain

Ask yourself these questions:

1. When you wake up from sleep are your jaws clenched or your teeth sore?
2. Does your jaw lock, pop, grate, click or snap?
3. Do you have frequent headaches? How long do they last? What area of the head?
   
4. Do you have trouble opening and closing your mouth?
5. Have you ever had a whiplash injury or had a blow to the head or jaw?

From time to time, you may suffer from soreness or tightness of the jaw. If the pain continues to get worse or the tightness progresses to a place where eating, smiling or yawning is difficult, then there is a possibility that there is some dysfunction of the Temporomandibular Joint (TMJ). This can also be called TMJ Syndrome or TMJ disorder. It most often affects people aged 20-40, however anyone can be affected by TMJ problems at any age.

Anatomy of TMJ

Where is the TMJ?

The Temporomandibular Joint is located where the jaw (mandible) meets the temporal bone of the skull.  The TMJ is comprised of muscles, blood vessels, nerves, and bones and each person had two TMJs, one on each side of your jaw.

There is a small articular disc that is located within the joint that has a small thin piece of fibrocartiledge, separating two synovial cavities filled with synovial fluid. This allows separate movements to happen within the same space. Movements of the jaw include opening/closing, left and right movement, and forward and back movements. The TMJ also allows movements needed for speaking, chewing, and making facial expressions.

Did you know the muscles that move the TMJ are the same muscles you use to chew food (muscles of mastication), the masseter, medial pterygoid, lateral pterygoid and the temporalis muscles?  Your Myotherapist will address these muscles when you visit Inner Outer Health.

How do I locate the TMJ?

You can find this joint yourself by placing a couple of fingers in front of your ear, and open and close your mouth. You can also placing your index finger in your ear. When you do this action you will feel the TMJ move from under your fingers.

What is TMJ dysfunction/ TMJ Syndrome?

The best ways to describe this is to view the YouTube video below.

Symptoms of TMJ Dysfunction

Symptoms of TMJ can be very diverse, however the most common symptoms include:

• Migraine-like headaches where the pain is located around the side of the head or behind the eyes
• Headaches (usually tension or sinus)
• Neck-aches particularly at the base of the skull
• Vertigo / balance issues
• Ringing in the ears
• Ear pain
• Problems chewing or opening/closing the mouth
• Clicking or popping jaw
• Sore cheek muscles
• Stomach pain
• Lower back pain
• Poor posture
• Teeth grinding or jaw clenching
• Facial pain or tenderness
• Locking of the jaw
• Jaw mis-alignment or bite problems

Causes of TMJ Dysfunction

There are many possible causes for TMJ dysfunction, including neurological, muscular, vascular, problems with the joint itself or hysterical conversion . Other causes could include:

• Degenerative diseases - such as osteoarthritis or rheumatoid arthritis.
  
• Trauma - from things such as teeth grinding or clenching, which can cause inflammation around the TMJ and surrounding muscles.
  
• Age-related wear and tear
• Hypermobility – this occurs when the ligaments around the TMJ become lax.
  
• Stress - related muscular tightening. During periods of stress, we release adrenaline which is a hormone that tells your muscles to tighten, ready for action… however, over prolonged periods of time, if stress is chronic then muscular tightness may present in the facial muscles, especially around the jaw, accompanied by teeth clenching or grinding at night.
  

Generally speaking, pain or restriction around the jaw (joint or muscles) that occurs over an extended period of time can be termed dysfunctional.

Over time, the disc of the TMJ can wear and become very thin, or changes may occur to the disc due to dysfunction, which may create impaired movement of the joint. When there is dysfunction present, if it is not treated early on it could lead to disc degeneration and TMJ Syndrome.

TMJ dysfunction can be classed into three different categories:

1. Myofascial – generally presents as muscular pain or discomfort in the muscles surrounding the jaw. Myofascial Pain Dysfunction (MPD) Syndrome is also being included here, as muscles may be in various states of tension or spasm due to various causes. It is believed that there is a connection between Myofascial pain and psychological or emotional stress. Teeth grinding or clenching may also be present. In this case, TMJ pain may be secondary to these events.
2. Joint - issues such as disc displacement, dislocation of jaw, or injury to the bones around the joint.
   
3. Arthritis/degenerative joint disease – inflammatory joint disorder that can manifest in the TMJ.

Any one or more of these categories may be present at once. Most people have fairly mild cases of the disorder, whereas others may have persistent and chronic issues with their TMJ. Disc displacement is not uncommon.

Symptoms of TMJ Dysfunction

TMJ ruins snack time

How to Treat TMJ Syndrome

Often, jaw problems can resolve in several weeks to months. The TMJ.org site states that “less is best” when it comes to TMJ treatment.

If you have recently experienced TMJ pain and/or dysfunction, you may find relief with some or all of the following recommendations. Treatment for TMJ Syndrome / TMJ Dysfunction / TMJ Disorder can include:

• Physical therapy such as myotherapy to treat the muscular aspects of the TMJ dysfunction
  
• Dry needling
• Occlusal (bite) adjustment
• Oral appliances such as a dental plate or mouthguard to help protect teeth from grinding at night
• TMJ implants
• Dental or orthodontic care may be required to adjust bite and jaw alignment
• Sleeping position by reduce the amount of time sleeping on your side

Self Care

The following recommendations are ways that you can self-treat your TMJ disorder.

• Ice/ Cool Therapy - icing the area can decrease inflammation and also numb pain and promote healing. Keep an ice pack wrapped in a tea towel or clean cloth. Use ice for 10-20 minutes, then rest the area for 40 minutes, and repeat if necessary.
  
• Moist Heat – using a heat pack or a hot water bottle wrapped in a warm, moist towel can reduce pain, and improve function.
  
• Soft Diet – avoiding hard, crunchy, and chewy foods gives your jaw a chance to rest a little. Also avoid stretching your mouth to accommodate such foods as whole fruits.
  
• Relax Facial Muscles – relax your lips, and keep teeth apart as often as you can. Make an effort to be mindful of this.
  
• Relaxation Techniques – various forms of relaxation can help you to deal with the pain of TMJ dysfunction. Techniques such as deep, slow breathing can enhance relaxation and assist in pain management. Relaxation massage, yoga, meditation and floatation therapy can also be helpful in reducing stress and aiding relaxation.
  
• Jaw Exercises – to increase jaw mobility and promote healing, you can try slow, gentle jaw exercises. Your Myotherapist can recommend exercises for your jaw.
  
• Side Sleeping – when you are side sleeping try and alternate sides and use a supportive pillow between your neck and shoulder.
  
• Chew Gum – at all cost avoid chewing gum as can greatly aggravate the area.
  

TMJ Muscle Exercises

At Inner Outer Health, we offer myotherapy which can help in the treatment of TMJ dysfunction by working through trigger points (knots) in the muscles around the jaw, neck, shoulders, and back and other techniques. Your Myotherapist can also give you specific exercises and stretches to do at home for your own self-treatment in between your sessions.

If you or someone you know is suffering from TMJ dysfunction, please share this information with them.