What is Temporomandibular Joint Disorder (TMJD)?
Temporomandibular joint disorder, or TMJD, is a common condition that can limit the natural function of the jaw, including opening/closing the mouth and chewing. The TMJ is a hinge joint that serves as a connection between your jaw and skull, located just in front of your ear. This unique joint structure allows for a variety of jaw movements in everyday life and when irritated, can be a potential source of head, neck, and facial pain.
More than 10 million people in the United States are affected each year, with women aged 20-40 being more often diagnosed compared to their male counterparts. TMJD is closely linked to individuals affected by neck pain, headaches, and ringing in the ears (aka “tinnitus”) and has been shown to be present in as many as 35% of patients who present to Physical Therapists for mechanical neck pain. While TMJD has a variety of potential sources, some of the more common causes include:
Postural Habits
While no posture is inherently “bad”, prolonged sitting postures as a result of modern lifestyles can all place the head and neck in forward positions, leading to increased strain on the joint, muscles and ligaments of the TMJ.
Chronic jaw clenching
Many individuals clench and grind their teeth at night when they sleep (aka. “Bruxism”) as well as during the day, often due to stress. This places excessive strain on the TMJ joint and the surrounding musculature.
Problems with jaw/teeth alignment
Referred to as a “malocclusion”, if your teeth are positioned in an unusual way, excessive stress is placed on the TMJ when performing everyday activities, leading to overuse of the muscles of the jaw.
Fracture
Following a traumatic accident to the face/head, a break in the bone of the lower jaw (aka. mandible) can cause TMJ stiffness and pain even once the injury has healed.
Surgery
Clients who undergo certain kinds of head/neck/facial surgery may experience a loss of TMJ mobility following their operation.
Lockjaw
Trismus, commonly known as “lockjaw”, this is where the jaw muscles spasm and the joint cannot be fully opened. This can occur due to local trauma, stress and can both be a cause and a symptom of TMJD.
Displacement
The soft-tissue and/or disc inside the TMJ (think similar to the meniscus of the knee or the discs between each spinal vertebrae) can get caught and cause popping/clicking and pain of the joint.
Arthritis
This can occur often years/decades after an initial injury to the TMJ, causing popping/clicking and jaw stiffness.
Signs and Symptoms
– Jaw fatigue
– Inability to open the mouth to eat or talk
– Pain when eating certain foods that require more chewing (i.e. steak, fruits, etc.)
– Ringing in the ears
– Dizziness
– Headache
– Popping, clicking, and/or catching sounds in the jaw
– Neck pain
– Facial or jaw pain
***IMPORTANT: New onset jaw pain when accompanied by chest pain, shortness of breath, left arm pain/numbness and/or nausea can also be a symptom of a heart attack.
Seek emergency medical attention if this occurs.
How can Physical Therapy help?
Not all jaw pain is the same and therefore, it is critical that you get evaluated by a skilled therapist who will assess the structures of the head and jaw as well as the muscles and joints of the neck and upper back that may be contributing to your symptoms. Most TMJ pain can be directly attributed to muscular guarding and tends to respond best to a utilization of both hands-on techniques (i.e. manual therapy) as well as exercise.
Your Physical Therapist will perform a specific, detailed examination and then prescribe the proper exercises that will help you become pain-free in the long term. If you are dealing with severe pain, your therapist may also utilize spinal manipulation and/or dry needling as well as prescribe a variety of exercises to relax the jaw muscles. Your therapist will also prescribe exercises to strengthen the neck, upper back and postural muscles as well as provide education on various stress-management strategies that are crucial for long-term symptom resolution.
Jaw pain can be frustrating, daunting, and severely impact one’s quality of life, but it doesn’t have to be that way! Here at MOTION RX, our therapists are uniquely trained to help you both find the root cause and address these issues for good so that you can get back to the activities you love, pain free. If you’re experiencing jaw pain that is holding you back from the things you want to do, give us a call!
References
1. Armijo-olivo S, Pitance L, Singh V, Neto F, Thie N, Michelotti A. Effectiveness of Manual Therapy and Therapeutic Exercise for Temporomandibular Disorders: Systematic Review and Meta-Analysis. Phys Ther. 2016;96(1):9-25.
2. Butts R, Dunning J, Perreault T, Mettille J, Escaloni J. Pathoanatomical characteristics of temporomandibular dysfunction: Where do we stand? (Narrative review part 1). J Bodyw Mov Ther. 2017;21(3):534-540
3. Butts R, Dunning J, Pavkovich R, Mettille J, Mourad F. Conservative management of temporomandibular dysfunction: A literature review with implications for clinical practice guidelines (Narrative review part 2). J Bodyw Mov Ther. 2017;21(3):541-548.