Ever heard of TMJ? What exactly is TMJ you may ask. Or what causes it? How do I know if my jaw pain is TMJ or just another headache? Are invasive therapy's my only treatment options, or can Chiropractic help? Here are a few insights into the causes and treatments of what cause's “Temporo-Mandibular Joint” pain aka TMJ.
You can locate the TMJ joint by putting your finger on the triangular structure in front of your ear. Then move your finger just slightly forward and press firmly while you open your jaw all the way and close it. You can also feel the joint motion in your ear canal. Open your jaw all the way and shut it. This simple movement would not be possible without the Temporo-Mandibular Joint (TMJ). It connects the temporal bone (the bone that forms the side of the skull) and the mandible (the lower jaw). Even though it is only a small disc of cartilage, it separates the bones so that the mandible may slide easily whenever you talk, swallow, chew, kiss, etc. Therefore, damage to this complex, triangular structure in front of your ear, can cause considerable discomfort.
How does the TMJ work?
When you bite down hard, you put force on the object between your teeth and on the joint. In terms of physics, the jaw is the lever and the TMJ is the fulcrum. Actually, more force is applied (per square foot) to the joint surface than to whatever is between your teeth because the cartilage between the bones provides a smooth surface, over which the joint can freely slide with minimal friction.
Therefore, the forces of chewing can be distributed over a wider surface in the joint space and minimize the risk of injury. In addition, several muscles contribute to opening and closing the jaw and aid in the function of the TMJ.
What causes TMJ pain?
In most patients, pain associated with the TMJ is a result of displacement of the cartilage disc that causes pressure and stretching of the associated sensory nerves. The popping or clicking occurs when the disk snaps into place when the jaw moves. In addition, the chewing muscles may spasm, not function efficiently, and cause pain and tenderness.
What causes damage to the TMJ?
Things such as major and minor trauma to the jaw, teeth grinding, excessive gum chewing, stress and other psychological factors, improper bite or malpositioned jaws, or arthritis can all cause damage to the TMJ.
What are the symptoms?
Some common symptoms are ear pain, sore jaw muscles, temple/cheek pain, jaw popping/clicking, locking of the jaw, difficulty in opening the mouth fully, and frequent head/neck aches.
The pain may be sharp and searing, occurring each time you swallow, yawn, talk, or chew, or it may be dull and constant. It hurts over the joint, immediately in front of the ear, but pain can also radiate elsewhere. It often causes spasms in the adjacent muscles that are attached to the bones of the skull, face, and jaws. Then pain can be felt at the side of the head (the temple), the cheek, the lower jaw, and the teeth.
A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the doctor will consider the possibility that the pain comes from TMJ.
A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the doctor will consider the possibility that the pain comes from TMJ.
There are a few other symptoms besides pain that TMJ can cause. It can make popping, clicking, or grinding sounds when the jaws are opened wide. Or the jaw locks wide open (dislocated). At the other extreme, TMJ can prevent the jaws from opening fully. Some people get ringing in their ears from TMJ.
The pain may be sharp and searing, occurring each time you swallow, yawn, talk, or chew, or it may be dull and constant. It hurts over the joint, immediately in front of the ear, but pain can also radiate elsewhere. It often causes spasms in the adjacent muscles that are attached to the bones of the skull, face, and jaws. Then pain can be felt at the side of the head (the temple), the cheek, the lower jaw, and the teeth.
A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the doctor will consider the possibility that the pain comes from TMJ.
A very common focus of pain is in the ear. Many patients come to the ear specialist quite convinced their pain is from an ear infection. When the earache is not associated with a hearing loss and the eardrum looks normal, the doctor will consider the possibility that the pain comes from TMJ.
There are a few other symptoms besides pain that TMJ can cause. It can make popping, clicking, or grinding sounds when the jaws are opened wide. Or the jaw locks wide open (dislocated). At the other extreme, TMJ can prevent the jaws from opening fully. Some people get ringing in their ears from TMJ.
TMJ Mouth Guards for Pain Relief
TMJ mouth guards are soft plastic protectors that slip over the upper and lower teeth to prevent grinding of the teeth. Guards make it more difficult to clench the jaws, an important first step in TMJ pain relief. Your dentist will take a mold of your upper and lower teeth to custom-fit your TMJ mouth guards for maximum comfort and efficiency.
Jaw Exercises for TMJ
TMJ exercises are designed to relax the jaw and eliminate clenching, and also to help in the correction of alignment problems. After careful analysis, your dentist may provide you with an appropriate series of very simple exercises to be performed in front of a mirror. The use of a mirror in TMJ exercises helps you see the misalignment that is one of the factors in TMJ syndrome. Gradually, the exercises will teach you control of the jaw muscles and eliminate clenching.
TMJ Bite Therapy
A process known as TMJ therapy, or bite therapy, is used by dentists to help find the causes of TMJ syndrome and provide long-term pain relief. TMJ bite treatment begins with a careful, detailed analysis of your mouth and jaw to find the causes of your disorder. For some, the issue may be jaw clenching; this can usually be attributed to stress or simply a bad habit. For others, the teeth may not come together evenly, a condition known as malocclusion. This can cause uneven use of the jaw and result in muscle pain. Dentists have several tools at their disposal to measure bite pressure throughout the mouth and formulate a plan for dental work that will correct malocclusion and provide TMJ pain relief.
How Can Chiropractic Help the Temporomandibular joint (TMJ)?
Chiropractic care for the temporomandibular joint (TMJ) can ease pain by correcting the misalignment between the spine and nervous system. Chiropractic can be effective at reducing the pain associated with TMJ, either when used alone or as a complement to other treatments. This is because, rather than change the diet or modify the teeth, it relaxes the muscles, adjusts the joint and uses specific trigger points to accurately re-position the jaw. When done successfully, this will not only relieve pain in the short run (as would medications or eating soft foods), but it will help prevent TMJ pain from returning.
Chiropractic treatment of the temporomandibular joint (TMJ) focuses on relieving tension in the muscles around the joints themselves—working both outside and inside the mouth, using massage and trigger point therapy. A trigger point is a very sensitive area made of muscle fibers. Trigger points feel like knots and may cause pain or even a twitching response when pressure is applied to them. A chiropractor can manipulate trigger points in such a way to alleviate the pain associated with them.
Trigger points common to TMJ include:
• Trapezius muscle, located at the base of the neck. Manipulating this trigger point can influence the areas behind the ear, at the temple and at the jaw bone.
• Sternocleidomastoid muscle, located along the neck from the collarbone to the ear. This trigger point can be used to relieve pain in the forehead, front of the jaw and around the eye socket.
• Masseter muscle, located at the back of the jaw. This refers to pain in the upper jaw, ear and above the eye.
• Medial Pterygoid muscle, located behind the molars on the jaw. This trigger point influences pain in the TMJ, as well as in the ear, nose, lower jaw, and the neck.
Adjustments to the joints can also be done by hand, using a technique that causes a tiny stretch inside the joint to release any fibrous attachments made by the body due to previous trauma. The chiropractor may also give the patient home exercises to help strengthen the joint and loosen the tight muscles.
In some cases, misalignment of the jaw that results from improper posture or a back problem can cause temporomandibular joint (TMJ) disorder. An approach to treating TMJ caused by misalignment in the neck and upper back is to perform chiropractic adjustments on the spinal joint in these areas. In addition, a chiropractor may use massage to relieve tight muscles in the back around the spine. This reduces the amount of stress put on the jaw so that other treatments to adjust the jaw will be more effective.
When these treatments are employed, motion of the jaw joint can improve and symptoms such as ear pain, jaw locking, headaches, and neck pain can be reduced.
Why use Chiropractic for Temporomandibular Joint Disorder?
While there are numerous ways to effectively treat temporomandibular joint (TMJ) disorder, scientific studies have shown that chiropractic was helpful in cases of TMJ. In a 2003 study, 15 participants were administered treatments with the Activator Method, which uses a tool that delivers high-frequency, low-impact adjustments. All participants showed improvements in the distance they could open their jaws and in pain measurements. Although this group was not compared to a group receiving traditional treatment, it shows that chiropractic treatments like the Activator Method show promise as an emerging treatment for temporomandibular joint disorder (TMD).
Many report relief and satisfaction with chiropractic care for temporomandibular joint (TMJ) disorder. In a survey of 192 members of a health maintenance organization published in 2003, nearly two-thirds reported using some form of complementary medicine to treat TMJ. Almost everyone surveyed used complementary approaches together with other traditional treatments, and the greatest satisfaction was reported for the hands-on alternative therapies, including chiropractic.
Chiropractic may be used alone or in conjunction with other treatment approaches. Medications can include anti-inflammatories, analgesics (pain killers) and muscle relaxants, as well as local injections of corticosteroids in severe cases. Application of hot and cold compresses also reduces inflammation. When teeth grinding or clenching is an issue, wearing a mouth night guard can help prevent these actions during sleep. Bite plates can help correct misalignment. Stress reduction, relaxation techniques, jaw-stretching exercises, and modifying chewing habits are all behavioral approaches that are proven effective.
Chiropractic may be used alone or in conjunction with other treatment approaches. Medications can include anti-inflammatories, analgesics (pain killers) and muscle relaxants, as well as local injections of corticosteroids in severe cases. Application of hot and cold compresses also reduces inflammation. When teeth grinding or clenching is an issue, wearing a mouth night guard can help prevent these actions during sleep. Bite plates can help correct misalignment. Stress reduction, relaxation techniques, jaw-stretching exercises, and modifying chewing habits are all behavioral approaches that are proven effective.
More research into chiropractic methods used to treat temporomandibular joint (TMJ) disorder are needed; meanwhile, evidence from existing studies as well as patient testimony suggest that chiropractic therapies are helpful in relieving TMJ symptoms
Doyle Chiropractic Clinic serves the communities of Bothell, Kenmore, Woodinville, and Lake Forest Park. Drs David Arthur and Suzie Shay have a combined 30 years of experience treating injuries related to car accidents, work, sports and Pediatrics. Please visit our website, www.bothellfamilychiropractic.com and our Facebook page facebook/doyleclinic.
References:
Journal of Manipulative and Physiological Therapeutics 2003 Sep;26(7):421-5.
Journal of Orofacial Pain. 2003 Summer;17(3):224-36.
Journal of Orofacial Pain. 2003 Summer;17(3):224-36.
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