TMJ
Are you experiencing excruciating pain in your jaw or having difficulty opening and closing your mouth? Then you may be suffering from TMJ disorder (TMD). TMJ pain is a common complaint we see and treat at our Edmonton health and wellness clinic.
TMJ pain is the 2nd most common musculoskeletal pain with about 33% of the population experiencing at least one TMJ symptom.
TMD is a condition that can be associated with more symptoms than just jaw pain. People that suffer from TMD may also experience headaches, ringing in the ears, and other health issues.
In order to really understand TMJ pain, we must consider a few different factors including anatomy, our daily environment, and psychological stresses.
What Is The TMJ?
TMJ stands for ‘temporomandibular joint’. The TMJ gets its name from two bones that connect your jaw (mandible) to the skull (temporal bone) on both sides of your head acting as a hinge-like joint. This joint allows you to open and close your mouth when you are eating, talking, yawning, and shifting your jaw from side to side.
The TMJ is more than just two bones however, the TMJ includes ligaments, tendons, muscles, and an articular disc that work together to allow for proper function.
The TMJ is held together by a few different ligaments that help to manage the forces and send sensory information to the brain. These ligaments attach the mandible to the temporal bone and provide stability to the joint. The muscles that surround the TMJ are also important in providing stability and movement of the joint. The primary muscles are known as the ‘muscles of mastication’ and include:
- Masseter
- Temporalis
- Lateral Pterygoid
- Medial Pterygoid
Aside from the muscles of mastication, there are other muscles that also have an influence on the function of the joint:
- Digastric
- Mylohyoid
- Stylohyoid
- Buccinator
Between the actual joint itself, there is a cartilaginous disc similar to the disc that can be found in the knee. This articular disc fills the space between the bones and acts as a cushion to allow efficient movement as you open and close your jaw. Here is a basic video of how the jaw opens and closes and some of the muscles work together:
Symptoms of TMD
When assessing for TMD, there are three common symptoms that patients will present with. However, not every patient will experience all three symptoms while others may experience all the symptoms.
- Jaw pain
- This is the most common symptom of TMD. Most people will feel pain in the muscles on the side of their face in front of the ear. Usually, it will feel tender or sore when poking or rubbing the muscle and when opening/closing the jaw
- Clicking or popping sounds
- If you are feeling a clicking or popping sound when you open and close your mouth, this is caused by the disc. From the video above, you can see how the disc moves as the jaw opens and closes. When we are suffering from TMD, the disc can be displaced (majority of the time, anteriorly) due to the jaw resting back further than normal.
- Movement dysfunction
- Overactive muscles of the TMJ can pull the jaw towards either to the left or the right when opening and closing the mouth. You may notice a shift to one side as you open your mouth or you may even see the jaw shift as you watch yourself in the mirror opening and closing your mouth.
Other symptoms
- Headaches
- TMD can often lead to headaches depending on the patient. With increased clenching and grinding, the muscles of mastication will become tight and overworked. The temporalis muscle is one of the muscles that can be overworked and since it is located on the side of the head behind the eyes, headaches can form in this area.
- Ear pain or ringing in the ears
- These symptoms aren’t as common as the others but since the TMJ is located in front of the ear, some people may feel referred pain in the ear. The nerves of the ear are the same as the nerve that innervates the TMJ, so inflammation in the TMJ can cause ringing in the ear as well as pain.
- Pain in the neck/shoulders
- Since some of the muscles of the shoulders and neck are attached in the area of the TMJ, Neck pain and shoulder pain may present. Also, posture as well as stress can affect the muscles of the neck, shoulders, and TMJ.
- Lockjaw
- This can be a more serious issue caused by TMD. Lockjaw refers to the jaw either not being able to open past a few centimeters or the jaw is ‘locked’ in an open position and you are unable to close it. This can be caused by either a dislocation of the joint or the disc is ‘stuck’ in a position and it is blocking the joint from opening or closing properly
What Causes TMJ Pain?
TMD is most commonly associated with an overuse injury or trauma to the face. Although you may not feel pain in the jaw, symptoms such as headaches can be directly correlated to TMD. There are many factors that can contribute to TMJ pain and they tend to accumulate together.
The main causes of this condition are:
- Teeth grinding/clenching
- Teeth grinding and clenching overwork the muscles of the TMJ which can lead to pain in the jaw. Like other muscles in our body, if we were to constantly flex them throughout the day (or night), we would begin to feel pain and soreness also. This is also known as bruxism. It can cause damage to the teeth and jaw muscles.
- Trauma
- If you have experienced a hit to the face or have been in a car accident, the sudden force can overstretch muscles and ligaments, affecting the alignment of your bite.
- Chewing gum
- Constant chewing will cause the muscles of the TMJ to become overworked and fatigued. This would be similar to doing dozens of repetitions, multiple times throughout the day with any other muscle group.
- Arthritis
- Osteoarthritis is a degeneration of the joint. When there is decreased space in the TMJ joint, it creates the opportunity for increased bone-on-bone rubbing which can lead to TMJ pain. This is similar to other joints in the body such as the hip or knee.
- Misaligned bite
- An uneven bite can cause increased stress and strain in the TMJ muscles. This is also known as malocclusion.
- Poor posture
- Poor posture can put extra strain on the neck muscles which can affect the jaw muscles. If our head and chin begin to drift forward while we are sitting or doing other activities, we may start to compensate with the muscles in the neck putting extra load through the muscles of the jaw
- Stress & Anxiety
- Increased stress can cause you to clench your jaw, overstressing the muscles and ligaments, leading to TMJ pain. Increased stress can also release stress hormones in the body, leading to increased inflammation in areas of pain.
- Poor sleep habits
- Lack of sleep can release stress hormones in the body which can result in increased inflammation when we are in pain. Also if we are sleeping on harder surfaces where increased pressure is placed on the TMJ, this can lead to more TMJ pain.
How We Can Help With Your TMJ Pain
As you can see, the TMJ is a complex joint with different moving parts in order to function well. However, most TMJ pain can be resolved with conservative care. Our skilled practitioners have different tools and techniques to help with the reduction of TMJ pain and to improve TMJ function.
Our team believes that conservative care should always be the first form of care when it comes to the treatment of conditions involving the muscles and joints.
Treatment options for TMJ pain may include:
- Chiropractic: a chiropractor can help identify and correct postural imbalances that may be contributing to TMJ pain
- Physiotherapy: a physiotherapist can work with you to identify and address any muscle imbalances or postural issues that may be contributing to your TMJ pain.
- Massage: A trained massage therapist can work on the muscles of the jaw and neck to help release tension and alleviate pain.
- Acupuncture: Acupuncture therapy can help to reduce muscle tension in the jaw by stimulating the muscles. This treatment works well in combination with laser therapy.
- Laser Therapy: Laser therapy is a non-invasive technique that can help to decrease inflammation in the jaw muscles. This treatment works well combined with acupuncture.
- Home exercises/relaxation techniques: Recommended exercises by our Edmonton chiropractor or physiotherapist to help improve jaw mobility and reduce tension in the jaw muscles
For more severe cases, we may recommend special treatments such as botox from your dentist (If you don’t have one, we work closely with a clinic we can refer you to) to co-manage your condition. Our clinic makes every effort to ensure you get to the right place for your care and to feel better.
What to Expect During Your First Appointment
Meeting your practitioner for the first time can be a little intimidating. At Enhanced Health & Wellness, we work with our patients to ensure they are as comfortable as possible.
At your first appointment, your practitioner will go over a thorough history to determine the cause and mechanism of your condition.
Before an exam and treatment are performed, they will review your comfort levels and possible things that you are uncomfortable with. Learning your thoughts about your condition and goals for treatment will help guide the treatment plan.
After a detailed exam is performed, treatment is administered the same day and a customized treatment plan will be created. The treatment plan will include: treatment options, education and advice, and possibly home exercises to work on.
Get TMJ Relief
In general, TMJ pain is common but manageable. Despite there being various reasons why someone can have TMJ pain, finding the right modalities and practitioners can help you address the underlying problem and decrease symptoms.
If you are experiencing jaw pain and can relate with the symptoms mentioned above, give Enhanced Health a call (780-431-1201) or you can book online with one of our skilled practitioners.
FAQ
Nope! Although dentists are experts on the teeth and the jaw, if you are feeling TMJ pain, it isn’t necessary for you to go to see a dentist prior to treatment. Our skilled practitioners can help you relieve TMJ pain without a referral.
The vast majority of people who have suffered from TMJ pain do not need surgery to find relief. Surgery is considered a last resort after more conservative treatment has been tried. Manual therapy, education on the TMJ, and a few exercises will help most people suffering from TMJ pain. Other forms of treatment are botox and a night splint that your dentist can perform to decrease the muscle tone. If all of that doesn’t work, then you may be a candidate for TMJ surgery.
A few tips you can try adding to your daily routine to reduce TMJ pain:
– Avoid clenching or grinding your teeth
– Avoid eating hard (ie. Carrot) or chewy (ie. Gum) foods
– Try some exercise or relaxation techniques for your TMJ
– Be mindful of your posture
– Wearing a night splint while you are sleeping to decrease TMJ stress
– Practice relaxation techniques like meditation
“I’ve been going here for years, and Dr. Kwan is a fantastic chiropractor. I’ve never had a bad visit. He listens and always knows what to do (jaw, lower back, ribs, arm/back). I’m constantly hurting myself, and under his care I’m slowly learning how to better care of myself (specific exercises and stretches, how to move my body in general).!”
