The Jaw joint, or Temporomandibular joint (TMJ), is a common source of discomfort.
The TMJ is the joint between the upper and lower jaws, which can be felt just in front of your ears when you open and close your mouth. Pain linked with this joint is referred to as TMJ dysfunction (TMD), and describes problems associated with the “chewing” muscles and the joints between the lower jaw (the mandible) and the front part of the bass of the skull (the temporal bone).
TMD is not usually a serious condition, but the symptoms of pain, clicking or popping, limited mouth opening can significantly affect the quality of life by making it uncomfortable to eat, drink, and talk.
How do I know I have TMJ dysfunction?
There are 3 main symptoms of TMD. These are: facial pain, restricted jaw movement, and joint noise.
- Pain & tenderness -usually located around the jaw, but may refer to side of the head, face, neck, and in ear.
- Restricted jaw movement – Pain with moving the jaw with difficulty opening the mouth with stuck or tight feeling in the jaw. Locking may also occur.
- Joint noise such as clicking, popping or grating noises with chewing or moving your jaw
- Other symptoms include: Headaches, Earache with “buzzing” (tinnitus) or a blocked sensation in the ear, Neck or Shoulder pain, Sleep disturbances, and Tenderness in the teeth from excessive grinding
What caused me to suffer with TMJ dysfunction?
There are many different factors that can lead to TMJ dysfunction:
- Muscle over activity causing jaw clenching or teeth grinding during sleep (bruxism) – this is usually stress related and causes the over working of the muscles of the jaw putting pressure on the joint.
- Postural or muscular problems for example those associated with how you sit at a computer in the work place.
- Joint wear and tear – osteoarthritis
- Joint injury – for example after surgery or a traumatic blow to the face
- Stress – some may have an inherent elevated sensitivity to pain or stress
- Uneven bite (malocclusion) – for example, when new fillings, dental crowns or dentures are fitted
- Joint or dental Infection
- Too much joint flexibility (hypermobility) or too little joint flexibility (hypomobility).
- Specific diseases – TMD may be associated with specific diseases such as rheumatoid arthritis, gout, or fibromyalgia.
- Sometimes there is no obvious cause.
What treatment do I need?
- The treatment of TMJ dysfunction will depend on the cause.
- If the dysfunction is due to postural or muscular problems, Osteopathic treatment or other physical therapy disciplines are initially the best course of action as they are non-invasive and use techniques such as gentle soft tissue massage and joint manipulation to help ease muscular tension in and around the joint and restore mobility, as well as working to improve posture.
- Osteopaths are also equipped with the skills to guide you on lifestyle changes and self-help approaches.
- Dental related issues, such as malocclusion, may need to be seen by your dentist or be referred to an orthodontist for correction.
- Plastic Mouth guards/Gum shields may be helpful if you grind your teeth. These are worn at night and are designed to reduce clenching and grinding.
- If you are in a lot of pain, you can alleviate it temporarily by taking pain-killers such as paracetamol, anti-inflammatories (aspirin or ibuprofen), or codeine. These should only be used in the short term as they do not address the cause of the issue. In certain circumstances if the pain does not respond to paracetamol or anti-inflammatory drugs, your doctor may prescribe stronger medication such as a muscle relaxant or antidepressant. In more severe cases a corticosteroid injection may be considered.
- Sometimes if infection or other specific issues are suspected as the cause you may need to be referred to your GP for further investigation.
- In very rare cases of severe TMD, your doctor may consider a referral to an oral and maxillofacial surgeon to discuss further treatment options.
- NOTE: Most cases of TMD improve over time and do not get worse, and will not require surgical intervention.
How can I help myself?
- Rest the joint by eating soft food and avoiding chewing gum.
- Heat packs can help relax the muscles, while cold compresses can help reduce pain and swelling.
- Gentle jaw stretching exercises – as recommended by your therapist.
- Avoiding opening the joint too wide until the pain settles.
- Avoiding clenching the teeth for long periods of time.
- Self massage to the muscles around the joint .
- Relaxation exercise to relieve stress e.g. Mindfulness training or CBT.
- Avoiding resting your chin on your hand.
What ever the cause of your TMD, there is likely to be an imbalance of the muscles that controlling the TMJ. If left untreated, these imbalance can make the joint more susceptible to wear and tear. For more information and help with your TMJ call Cheadle Osteopathy on 0161 478 1877.